The House of Representatives Joint Committee on Health and Trade and Industry adopted House Resolution No. 973 urging the Department of Health (DOH) to adopt harm reduction measures, particularly the use of electronic cigarettes (e-cigarettes or “vapes”), as an alternative for smokers as part of the country’s National Tobacco Control Strategy.
In his sponsorship speech during the joint committee hearing held recently, HR No. 973 author Rep. Anthony Bravo (Coop-NATTCO Party-list) pointed out that the Philippines is a signatory to the Framework Convention on Tobacco Control (FCTC), which defines tobacco control as a range of supply, demand, and harm reduction strategies that aim to improve the health of a population by eliminating or reducing their consumption of tobacco products and exposure to tobacco smoke.
“This FCTC provision is a recognition that harm reduction measures can be considered for tobacco control,” said Bravo.
According to Bravo, harm reduction is a strategy directed toward individuals or groups that aims to reduce the harms associated with certain behaviors. In recent years, harm reduction has been successfully applied to sexual health education in an attempt to reduce both teen pregnancies and sexually transmitted diseases, including HIV. Programs using a harm reduction philosophy have also successfully lowered risky alcohol use among adolescents.
Bravo cited Dr. Konstantinos E. Farsalinos, a leading expert on tobacco harm reduction and e-cigarettes, who said that appropriate regulation of e-cigarettes can help prevent serious sickness in and the premature death of millions of cigarette smokers in the Philippines. During his visit to Manila in April 2017 when he spoke on tobacco harm reduction and e-cigarettes in a series of media events, Farsalinos urged the Philippine government to create a regulatory framework for e-cigarettes that is reasonable, proportionate, and realistic. He stressed that the regulatory framework for e-cigarettes “must be different from regulation of tobacco cigarettes; otherwise, people may be deceived into thinking that e-cigarettes are the same as tobacco cigarettes.”
Farsalinos noted that an appropriate e-cigarette regulatory framework is important to ensure product quality; promote harm reduction products only to intended populations (i.e. smokers and former smokers); maintain a competitive advantage for harm reduction products compared to smoking (price, availability, accessibility; and promote research to monitor population use and develop better (and even safer) products.
Farsalinos also noted that nicotine is the reason why quitting smoking is very difficult. However, he explained that while smoking is a leading cause of heart disease, stroke, and lung cancer, among many others, these diseases are not caused by nicotine. “People smoke for nicotine but die from the tar. Tar refers to the combustion products of cigarettes produced by the burning of organic matter, dried tobacco leaf, something which is not present in e-cigarettes.”
A Research Fellow at the Onassis Cardiac Surgery Center and University of Patras in Greece, Farsalinos has been conducting research on e-cigarettes as principal investigator since 2011. As of 2016, he has published more than 40 studies and articles in international peer-reviewed scientific journals about smoking, tobacco harm reduction, and e-cigarettes.
Addressing Rep. Angelina Tan (Quezon, 4th District), Chair of the Committee on Health, Bravo asked the Committee to urge the DOH to adopt harm reduction measures for tobacco control. “I support our measures against cigarette smoking. However, I am asking the DOH to consider all possible avenues to help smokers quit. I propose the United Kingdom model.”
Bravo was referring to the UK Tobacco Control Plan 2017-2022, which clearly states the British government’s intention to support consumers in stopping smoking and adopting the use of less harmful nicotine products, particularly e-cigarettes. In 2016, an estimated 2 million consumers in England used e-cigarettes and completely stopped smoking and a further 470,000 consumers in the country were using e-cigarettes as an aid to stop smoking. The UK Tobacco Control Plan stated that the best thing smokers can do for their health is to quit smoking, but acknowledged that the evidence is increasingly clear that e-cigarettes are significantly less harmful to health than smoking tobacco.
The UK Tobacco Control Plan cited the recommendation of Public Health England (PHE) about the non-coverage of e-cigarette use by smoke-free legislation and that e-cigarettes should not routinely be included in the requirements of an organization’s smoke-free policy. An operationally autonomous executive agency of the UK Department of Health, PHE published an expert independent evidence review in August 2015, which concluded that e-cigarettes are around 95 percent less harmful than smoking and that e-cigarettes may be contributing to falling smoking rates among adults and young people in the UK. The British government said that it welcomes innovation that will reduce the harms caused by smoking.
Bravo appealed to the DOH to consider adopting the British government’s approach. “E-cigarettes are already available in the local market and are an existing resource that we can tap to stop cigarette smoking. This approach is evidence-based; what’s stopping us from looking at the evidence? If the evidence shows e-cigarettes are harmful, then we stop. But if overall the evidence shows e-cigarettes are much less harmful than regular cigarettes and actually improve the health of smokers who switch to them, I think e-cigarettes are worth considering.”