The Philippine College of Chest Physicians (PCCP) should consider following the lead of the British Medical Association (BMA), which recently reversed its negative position on electronic cigarettes (e-cigarettes or “vapes”) and now supports their availability as a means to reduce the harm caused by smoking cigarettes.
“We call on the PCCP to carefully look at the reasons behind the BMA’s about-face on e-cigarettes. As the premiere specialty organization of Filipino pulmonologists and acknowledged authority in pulmonary medicine in the Philippines, the PCCP can be a huge influence in the adoption of tobacco harm reduction measures in the country that could potentially save millions of Filipino lives,” said Tom Pinlac, President of the consumer advocacy group The Vapers Philippines.
According to Pinlac, local tobacco harm reduction advocates including The Vapers Philippines, have been urging the Department of Health (DOH) to emulate the British government’s anti-tobacco policy, which supports consumers in stopping smoking and promotes the use of less harmful nicotine products, particularly e-cigarettes. Last year, about 2 million people in England used e-cigarettes and completely stopped smoking while nearly half a million more were using e-cigarettes as an aid to stop smoking.
BMA reverses position on e-cigarettes
In its position paper “E-cigarettes: Balancing risks and opportunities”, which was released on 29 November 2017, the BMA stated, “Increasing numbers of smokers are using e-cigarettes, with many people finding them helpful in cutting down or quitting cigarette use. There are clear potential benefits to e-cigarettes in reducing the harms associated with smoking, and consensus that e-cigarette use is likely to be significantly safer than smoking. It remains important, however, that in realizing any benefit to health, any potential risks associated with e-cigarette use are minimized.”
Written specifically for policymakers, the BMA paper aims to highlight the association members’ concerns, and potential opportunities surrounding the use of e-cigarettes. It sets out what the BMA believes is an appropriate policy response, taking into account the evolving regulatory and policy environment for these devices in the UK. The BMA is the professional association of doctors in the UK.
The BMA paper has three key messages for policymakers on tobacco harm reduction: First, there is a growing consensus that e-cigarette use is significantly less harmful than smoking. Second, e-cigarettes are the most popular device used in attempts to stop smoking. Although there is a lack of high quality research proving “effectiveness” as required for drugs, most reported studies demonstrate a positive relationship between e-cigarette use and cessation. Third, consumer regulations and feasible standards currently in force in the UK should be kept under review but are sufficient to address concerns about e-cigarette use, something which would not have been possible if e-cigarettes were regulated as medicines, noted the BMA.
Appropriate e-cigarette regulation is crucial
The BMA stressed that the way in which e-cigarettes are regulated will influence their potential to reduce tobacco-related harm. All e-cigarettes presently available in the UK are regulated as consumer products, and there are now over 2.9m people using these devices. The wide availability of e-cigarettes as an alternative to tobacco is likely, overall, to be playing a positive role in supporting tobacco-harm reduction, and consumer regulations will ensure a minimum standard of product quality.
Prior to the introduction of regulations contained within the Tobacco Products Directive (TPD), the BMA supported calls for e-cigarettes to be regulated as medicines, on the grounds that this would help ensure their efficacy, quality and safety, and bring them in to line with other NRT products. “However, no medically licensed products have been brought to the market yet…[which] is most likely because of the prohibitive costs associated with the application process and manufacturing. There are also particular concerns that licensing and presentation as medicines may reduce the appeal of e-cigarettes to smokers,” the BMA explained.
The TPD is the set of European Union regulations covering sales of all tobacco products, including cigarettes and e-cigarettes. It was originally created in 2001, but was revised in 2014 to include e-cigarettes.
“With appropriate regulation, e-cigarettes have the potential to make an important contribution towards achieving the BMA’s ambition of a tobacco-free society, leading to substantially reduced mortality from tobacco-related disease,” the BMA paper stated.