Now the usual “international experts” have shown up supporting industry efforts to weaken regulation of e-cigs and HTP in the Philippines

Under pressure from industry, the Philippine Congress has passed a retrograde bill that would roll back regulation of e-cigarettes and heated tobacco products. Medical and health groups, as well as the government’s own Department of Health, are urging President Rodrigo R. Duterte to veto the bill, known as the Vaporized Nicotine Products Regulation Act.

The need for stronger–not weaker–regulation of e-cigarettes is illustrated by the ad (above) selling an e-cigarette that includes images of Mickey and Minne Mouse. And it only costs US$6.

Not surprisingly, this debate has attracted the attention of “international experts” who are cheerleading for the industry bill. According to a March 7, 2022 report in the Maniia Bulletin:

  • David Nutt: “My research nearly 10 years ago showed vaping to be at least 25 times less harmful than cigarettes and many subsequent studies have confirmed this risk ratio. The Philippines would surely benefit in the same way if vaping was encouraged over cigarettes like it is in the UK and New Zealand.”

It is true that Nutt led a group that concluded, without citing any specific evidence, that e-cigarettes were 95% safer than cigarettes. This old claim has been thoroughly discredited.

Most important, by emphasizing what Nutt said 10 years ago, he ignores the fact that scientific knowledge of e-cigarettes has been rapidly growing. For example, Physicians for a Smoke-free Canada recently published an excellent summary of the current state of the science on e-cigarettes, including a graph showing how fast the knowledge has been accumulating:

Ten years ago, there were only 54 papers published on the health effects of e-cigarettes; today there are over 10,486 papers.

Why aren’t Nutt and his friends talking about any of that evidence?

Most likely it is because of the rapidly growing evidence that e-cigarettes have immediate and severe effects on the cardiovascular and pulmonary systems, among other adverse effects. Another thing we didn’t know 10 years ago is that, like cigarettes, e-cigarettes increase ACE2 activity and SARS-CoV-2 spike binding in vapers, the key step in getting infected with COVID-19.

  • Nutt also said: “The fear that vaping will lead to young people taking up cigarettes has been shown to be unfounded by the US data that reveals the most dramatic declines in youth cigarette smoking ever on account of them using vaping instead.”

This is just wrong. While it is true that youth cigarette smoking continued to drop (albeit more slowly) after e-cigarettes came of the market, there was a much larger increase in youth e-cigarette use, with the result that overall youth nicotine addiction increased.

The same thing happened in vape-friendly New Zealand, where the increase in youth e-cig use was many times bigger than the small decrease in smoking, which dramatically slowed since e-cigarettes came on the market.

  • David Sweanor: “President Duterte can embolden entrepreneurs and empower consumers to unleash a public health revolution by signing the vaping law.”

This statement ignores the reality that most important e-cigarette products and all the heated tobacco products are produced or owned by multinational tobacco (cigarette) companies.

  • Peter Hajek: “Regulators are sometimes lobbied to ban EC and HTP with claims that these products lure children to smoking. The argument is false. These products, in fact, deflect young nicotine seekers away from smoking.”

As shown in the graph immediately above, this is not true. If what Hajek says is true, total tobacco use (e-cigs plus cigs) would be dropping not increasing.

Quite the contrary, e-cigarettes are attracting large numbers of youth at low risk of initiating tobacco use with conventional cigarettes. Once kids start, the odds that they will go on to cigarettes is increased by a factor of 2-5.

  • Hajeck also said: “Population data suggest they also help smokers who purchase them as a consumer product. The increase in use of reduced-risk nicotine products and their sales have been accompanied by decreases in smoking prevalence and cigarette sales. The triangulated evidence suggests that EC help smokers quit and have the potential to replace cigarettes on the population scale.”

While randomized trials in which smokers are given e-cigarettes by medical professionals often in combination with counseling, e-cigarettes as consumer products show no cessation benefit or actually make it harder to quit.

  • Tom Glynn: “In the US, for example, the percentage of smokers in the population has dropped from more than 40 percent in the early 1960s to about 14 percent today, representing millions of lives saved from the ravages of cigarette smoking.”

Glynn is correct that we have made a lot of progress in reducing smoking since the early 1960s. That is because of smokefree laws, taxes, restrictions on advertising, increasing the minimum age for sale of tobacco products, and other proven public health strategies that have “softened” the smoking population. It had nothing to do with e-cigarettes, other than the industry’s development of e-cigarettes and heated tobacco products as a way to hold on to customers who would otherwise just quit.

The bottom line: President Duterte and Philippine policy makers should act based on the current best available science and not listen to people stuck making ten-year-old arguments.

March 10 update: List of authorities and groups urging a veto grow.

Published by Stanton Glantz

Stanton Glantz is a retired Professor of Medicine who served on the University of California San Francisco faculty for 45 years. He conducts research on tobacco and cannabis control and cardiovascular disease/

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