VERA FILES FACT SHEET: Smoke-Free Alternatives to Cigarettes Explained

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Barely 15 months after President Rodrigo Duterte banned “the use, sale or purchase of electronic cigarettes and tobacco products” for people under the age of 21, the House of Representatives approved a bill lowering the minimum age for people who can buy heated tobacco to 18 years. (HTP) and electronic nicotine / non-nicotine delivery systems (ENDs / ENNDS).

Bill 9007 or the Law on the Regulation of Non-Combustible Nicotine Delivery Systems, passed on third and final reading last May, also authorizes, among other things, the online marketing and sale of HTP and END / ENNDS, subject to guarantees. The counterpart measure in the Senate is still pending at committee level.

“By recognizing the principle of harm reduction, we envision that this bill will contribute to the protection of public health, not only for smokers but also for current adult Filipino smokers,” said Representative Sharon Garin, the one of the supporters of the bill.

The tobacco industry promotes HTP and END / ENNDS as smokeless alternatives to cigarettes for smokers who wish to quit smoking.

When he signed Executive Decree No. 106 on February 26, 2020, Duterte stated that “there is a need to regulate the access and use of ENDS / ENNDS, HTP and other new tobacco products, to deal with the serious and irreversible threat to the public. health, prevent the initiation of non-smokers and young people, and minimize risks to the health of users and other parties exposed to emissions.

Three months before signing EO 26, the president announced that he would ban the use and import of e-cigarettes and stop anyone using them. “It’s toxic and (the) government has the power to take action to protect public health and the public interest,” said Duterte, a former smoker.

While cigarettes are by no means obsolete in the Philippines, new alternative tobacco products, which take many forms, are gaining ground.

Here are five things you need to know about smokeless tobacco alternatives:

What are HTP and ENDS / ENNDS?

Heated tobacco products or HTP and electronic nicotine / non-nicotine delivery systems (ENDS / ENNDS) are two new alternative products, which are said to be less harmful than smoking. These are tobacco products heated to much lower temperatures than ordinary combustible cigarettes. Because no combustion is involved, both do not produce ash or smoke.

What is the difference between HTP and ENDS / ENNDS?

Tobacco leaves heat treated with HTP in a specific temperature range to create an aerosol that users inhale.

ENDS / ENNDS, on the other hand, do not use tobacco leaves. Often grouped together with electronic vapor products or “vapes” and electronic cigarettes, these use an electrical coil called an atomizer, which heats a liquid called e-juice, to produce an aerosol inhaled by the user.

Do HTPS and ENDS / ENNDS contain nicotine?

In a 2019 explainer published by Philip Morris International (PMI), an American tobacco company, HTP and most e-cigarettes contain nicotine, but some e-liquids are nicotine-free.

Nicotine is “naturally present” in tobacco used in HTP, the commentator noted.

In electronic cigarettes, nicotine derived from tobacco is added to the electronic juice used in the product. E-juice is available in a variety of flavors and can contain many other additives besides nicotine.

Nicotine is one of the reasons people smoke, according to PMI. In order for smokers to quit regular cigarettes in favor of new alternative tobacco products, these “generally have to contain nicotine,” he said.

Are HTP and ENDS / ENNDS safe?

No they are not.

HTP and most e-cigarettes contain nicotine, which is addictive and not without risk, as PMI noted in a Frequently Asked Questions article. Nicotine can affect brain development in adolescents and young adults, according to a fact sheet from the United States Centers for Disease Control and Prevention (CDC).

As a relatively new product, there are as yet no studies detailing the short and long term effects of using HTP and ENDS.

However, evidence shows that HTP emissions still contain harmful ingredients. The aerosols generated by ENDS / ENNDS contain toxic substances that are harmful to users and non-users exposed to second-hand aerosols, according to an explicator from the World Health Organization (WHO).

A 2013 US national study on alternative use of tobacco products and smoking cessation published in the American Journal of Public Health (AJPH) noted that the use of smokeless tobacco “has been associated at an increased risk of cancer of the mouth, esophagus and pancreas; myocardial infarction and stroke; oral disease; and reproductive problems.

PMI claims that the illnesses associated with smoking are primarily caused by inhaling harmful chemicals formed when tobacco is burned. Since new tobacco products do not involve combustion, the tobacco industry claims that smokeless alternatives are safer than regular cigarettes.

Do HTP and END / ENNDS help smokers quit smoking?

HTP has not been scientifically proven to help smokers quit, according to the US CDC.

Likewise, the WHO has said that the potential of ENDS as a smoking cessation intervention is unclear in part because of many ENDS products and the low certainty surrounding many studies.

While there are anecdotal claims that smoke-free alternatives are effective smoking cessation tools, no long-term controlled clinical trial has established this as a fact, according to the 2013 study.

Sources

House of Representatives, vol. 5: Sheet n ° 19, p. 31, sponsorship speech by Representative Garin, March 22, 2021

Official Journal, Executive Decree No. 106, Art. 2020, February 26, 2021

John Hopkins Medicine, 5 vaping facts you need to know

Centers for Disease Control and Prevention, Heated Tobacco Products: What’s the Result?

World Health Organization, Heated Tobacco Products: A Brief

Philip Morris International, Heated Tobacco Products: How Are They Different and Similar to Electronic Cigarettes ?, October 18, 2019

Philip Morris International, Who we are

Philip Morris International, Top 15 Myths About Smoke-Free Alternatives: Frequently Asked Questions, October 1, 2019

Centers for Disease Control and Prevention, About Electronic Cigarettes (E-Cigarettes)

World Health Organization, Tobacco: electronic cigarettes, January 29, 2020

American Journal of Public Health, Alternative Tobacco Product Use and Smoking Cessation: A National Study, May 2013


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