Take it from WHO: ENDS, HTPs work better

January 21, 2020

We’re the sum total of what has happened to us and how we’ve processed it. That’s what makes us us. It’s all neurochemistry. -- Replicas

The United Nations, it may be conceded here, is the global equivalent of your neighborhood village association.

And, quite admittedly, it is a political organization  It decides or settles issues through the votes of its member-states.

But its attached, specialized agencies are not beholden to the UN leadership or the General Assembly; they are broadly autonomous or independent.

And so if Malacañang cannot accept the position or stand of the UN on certain political issues, particularly on the purely domestic affairs of its member-states, perhaps it should at least consider the findings and recommendations of its agencies, especially one whose main mission is promoting public health.

In fact, if the Palace is truly committed to promoting public health and the general welfare of the people, it should be as aggressive and passionate in promoting alternatives to cigarette smoking as it is in encouraging people to use a specialized face mask to protect themselves from very fine and extremely harmful volcanic dust spewed out by Taal Volcano.

But while volcanic ash emissions are not daily occurrence, toxic fumes generated by cigarette smoking are decidedly clear, present, verifiable, and constant hazards to public health.

Luckily, smoking-cessation devices provide harm reduction to tobacco consumers.

In fact, no less than the World Health Organization has finally admitted that e-cigarettes are less injurious relative to cigarettes.

The acknowledgment came from Dr. Ranti Fayokun, World Health Organization representative and scientist in the National Capacity-Tobacco Control Prevention of Non-Communicable Diseases, during the hearing on vaping regulation conducted by the House of Representatives last month.

Fayokun’s admission was made following the WHO’s cautious stand on e-cigs despite the mounting scientific evidence that they are less harmful than traditional cigarettes.

Public Health England has insisted that e-cigs are 95 percent  less harmful than tobacco and has encouraged smokers who can’t quit smoking to switch to the less harmful alternatives.  

The National Academies of Sciences, Engineering and Medicine in 2018 released a report stating that “ completely switching from cigarettes to e-cigarettes will reduce exposure to numerous toxicants and carcinogens found in cigarettes”.  

A ban on e-cigs and heat-not-burn tobacco products would only create a black market that is bound to be disastrous to public health, according to international public health experts who attended a hearing.

"If you ban them, there will simply be a black market. When the United States banned alcohol in the 1900s, that did not work out," said. Dr. Andrew da Roza.  

“They [World Health Organization) are saying if you are a country that cannot produce regulation and cannot enforce regulation, you must ban. That, to me, is a contradiction. A country cannot regulate perfectly, but the last thing it should do is ban because the black market will proliferate. This is an issue that is extremely important to children.  If we ban things, if we do not regulate things, we create a black market that does not care about children, that does not care about elderly people, that does not care about us at all,” the addictions psychotherapist and lawyer, said in the congressional hearing.  

Da Roza, who holds a Master’s degree in counseling from Monash University in Australia, said e-cigs,  HTPs , and other electronic nicotine delivery systems proved effective in weaning smokers away from regular tobacco consumption which is extremely addictive and powerful, noting that: “E-cigarettes are twice as effective as NRTs (nicotine replacement therapies).” .

“New technologies give public health policy a unique opportunity to eliminate cigarettes in a single generation. I truly believe that. We can have a smoke-free world if we use these heat-not-burn products and if we use these e-cigarette products,” he said.

He said instead of a ban, the government should support and incentivize safer technologies that would free people from the scourge of cigarette smoking.

“Any regulation that slows down the developments in science means the people of the Philippines will not benefit from safer products. The government, in my humble opinion, should be investing in research on e-cigarettes and heat-not-burn products,” the addiction and legal expert  said.

He noted that e-cigs proliferate because they are attractive to smokers.  “We need to regulate them, not ban them,” he stressed..

“The health of the nation is at stake, and I believe there is an urgent need to follow the UK model of regulation. It is a working model, and it is extremely successful,” he said.

Da Roza warned that cigarettes are extraordinarily addictive as smokers use them regularly on a daily basis.

“It has a very powerful effect on the brain. If you are feeling depressed, smoking will lift your depression. If you are feeling anxious, smoking will calm you down. If you are feeling sleepy, smoking will pick you up,” he said.

“People are genetically geared to be vulnerable to enjoy smoking and to be tolerant to nicotine. They are sold to children in single cigarettes in the Philippines. They are horrible. They are available and cheap enough, and all children know about it,” he said.

Da Roza said that while NRTs deliver nicotine in a safer way, they are not as effective as e-cigs in making people quit smoking.

“NRTs vs. e-cigarettes show that e-cigarettes are twice as effective as NRTs. This really understates the value. That huge difference is rarely seen in sales of cigarettes,” he said.

Citing Japan, a nation of heavy smokers, the lawyer and therapist said: “When heat-not-burn products entered Japan, in three years, 30 percent less cigarettes were bought. That's how attractive these products are. That is a worldwide success story of historical proportions.”

Da Roza said NRTs are less effective because they do not substitute for the sensation in the mouth of smokers.

“It does not substitute for cigarettes. It does not substitute for the social life. It is really no substitute. However, heath-not-burn products and e-cigarettes are substitutes because of the social life wrapped around it, except that they are so much healthier,” he said.

He said that to become an effective tool in harm reduction, e-cigs and HTPs “should be more accessible to smokers than cigarettes at a price point equal to or less than cigarettes”.  

“Because we want smokers to switch and because smokers in the Philippines tend to come from lower socioeconomic levels, from people with mental illnesses, from people with addictions, these prices are extremely important to the Philippines. The lower the price, the more success you will have in smoking cessation. You can have a zero smoking nation.

“They should not be regulated in the same way as cigarettes,” Da Roza said. “E-cigarettes are a net benefit to public health. They should not attract sin tax. It is quite the reverse. They should attract government subsidy because they are net benefit to public health”.

Da Roza described ENDS as a “leapfrog technology,” which does not require governments to spend millions and millions of pesos in discovering new solutions.

“The Philippines must take up this sword. Banish cigarettes for the sake of our children, for the sake of our elderly and for the sake of everyone who smokes,” said Da Roza, suggesting that government should instead get behind scientific studies for the development of e-cigs.

Behold God’s glory and seek His mcrcy.

Pause and pray, people.