PH champions global tobacco control treaty’s harm reduction principle

MANILA, Philippines — The Philippines’ progressive measures to address the smoking problem achieved a milestone with the passage of the Vape Law, but the World Health Organization’s (WHO) global tobacco control treaty continues to disregard harm reduction as a proven approach to help smokers quit.

“The Vape Law acknowledges the need for less harmful alternatives for smokers, and Congress, by passing this law, has shown its support for science-based public health policy,” said Dr. Lorenzo Mata, president of Quit For Good, a non-profit organization promoting harm reduction to mitigate the damage caused by cigarettes.

Local and international public health experts support the mounting scientific evidence that novel tobacco products like heated tobacco, oral nicotine and vape products are significantly less harmful than smoking. Countries such as the UK, New Zealand and Japan have already embraced these products as proven tools to reduce the harm of smoking.

Senate President Juan Miguel Zubiri, in his sponsorship for the Vape Bill before its enactment, underscored the importance of providing Filipino smokers with alternatives to combustible cigarettes. “We’re trying to look for alternatives for them.  There is an alternative.  Until they finally get off these gadgets, let’s give them an alternative to a better life,” he said.

READ: Vape law to regulate new products, save adult smokers and protect minors – advocates

Professor David Sweanor, chair of the advisory board of the Center for Health Law, Policy and Ethics at the University of Ottawa, said the passage of the Vape Law in the Philippines could unleash a public health revolution.

Dr. Konstantinos Farsalinos, a Greek cardiologist and a leading researcher on tobacco harm reduction, also lauded the Philippines for making “such an achievement in such as difficult region.”

Dr. Alexander Wodak, the former director of the Alcohol and Drug Service at St Vincent’s Hospital in Sydney, Australia, said other Asian countries were moving in this general direction, “but not as far advanced as the Philippines.”

“Let us hope that this development in the Philippines would accelerate the move to tobacco harm reduction throughout the region,” said Dr. Wodak.

Roberto Sussman, an associate professor at the National University of Mexico (UNAM), described the enactment of the Vape Law in the Philippines as “a ground-breaking event that will influence countries in Asia, Latin America and Africa.”

Harm reduction is one of the three pillars of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC), recognizing it as a public health strategy along with demand and supply reduction.

Mata explained that the Philippines passed Republic Act No. 11900 or the Vaporized Nicotine and Non-Nicotine Products Act of 2022 to regulate smoke-free alternatives considered far less harmful than traditional cigarettes. “The Vape Law reflects the government’s position that innovative smoke-free products, proven by scientific research to be far less harmful than traditional cigarettes, should be regulated as options for smokers who wouldn’t quit otherwise,” Dr. Mata said.

He stressed the importance of aligning the Philippines’ FCTC stance with the Vape Law, especially considering the growing acceptance and promotion of THR worldwide. “Our position in FCTC should be in line with this law, especially as many other countries now also accept and promote tobacco harm reduction,” he added.

Mata cited examples of countries like the United Kingdom, Japan and Sweden, which have substantially reduced their smoking rates by allowing smokers to switch to less harmful alternatives such as e-cigarettes, heated tobacco, and oral nicotine. He highlighted annual reviews by the UK’s Office for Health Improvement and Disparities demonstrating the reduced risks associated with novel tobacco products compared to smoking.

He joined other public health experts in calling for the WHO FCTC to incorporate THR principles, allowing smokers access to safer alternatives. Dr. Mata also criticized the WHO for failing to respect article 1(d) of the FCTC preamble, which explicitly mentions “harm reduction strategies” as a crucial pillar of tobacco control.

Representatives from countries that are signatories to the WHO FCTC will meet in Panama for the 10th Conference of the Parties this year to address major topics, including the treatment of “novel and emerging tobacco and nicotine products.”

Mata said that in the Philippines, more than a million former smokers have already switched to smoke-free products to reduce their exposure to smoke, underscoring the need for less harmful alternatives.

“I have been a doctor for over 40 years, and I know how difficult it is for smokers when they have no alternatives that are less harmful. They get stuck with the deadliest product in the market,” he said. “After conducting studies ourselves, we were convinced that the use of vaporized nicotine and non-nicotine products was definitely less harmful [than smoking combustible cigarettes] and could be considered a pragmatic middle ground to which we should bring our current adult cigarette smokers.”

Supporters of the Vape Law contend that, after a thorough review of scientific evidence, nicotine products that do not involve burning are less harmful than cigarettes and other tobacco products that are burned. 

Supporters of the law are also convinced that vaporized nicotine and non-nicotine products (VNNPs) and novel tobacco products should be regulated and taxed differently from cigarettes to encourage adult smokers to switch to these products.

Mata said the Vape Law of the Philippines could also serve as a model legislation for other countries seeking to provide their smoking population with less harmful alternatives.

Asa Saligupta, director of ENDS Cigarette Smoke Thailand (ECST), urged countries like Thailand to study the case of the Philippines, which passed the Vape Law in recognition of the role of tobacco harm reduction (THR) in the campaign against smoking.