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Culture

The Unfolding telenovela on e-cigarette regulation

While criminality liability remains a hot topic these days, another age debate is brewing in congress on these smoking alternatives.
Susan Claire Agbayani | Jan 29 2019

Tobacco use dropped nearly 6 per cent in six years—from 2009 to 2015—among adult Pinoys. And yet the number of young Filipino smokers increased by four percent.

According to the Global Youth Tobacco Survey done in 2015, 4 in 10 students have heard of e-cigarettes. For every one person in 10 who will “try” to puff one, more than half will do it out of curiosity, four will try the flavors, three will do it because of the influence of peers, and two will do so because they perceive it to be “healthier” than cigarettes.

While the talk of social media and children’s rights group continues to be the lowering of the age of criminal liability to 9 years old, or 12 as of recent developments, another age-related issue is brewing in the Congress halls: If passed by both houses of Congress, the sale of e-cigarettes to minors “or to young persons (aged 21 years and below) shall be prohibited,” says Congressman Jose Enrique S. Garcia III in an e-mail to ANCX.

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If the Philippine Pediatric Society (PPS) had its way though, it would have pushed for age 25.

“The maturation age of the brain is reached by (one’s) mid-20s–particularly the prefrontal cortex–which is the seat of executive function responsible for mood, impulse and behavior control,” says Dr. Riz Gonzalez, Chair of the PPS-Tobacco Control Advocacy Group (PPS-TCAG) who represented PPS during the hearing on e-cigarettes at the Department of Health (DOH) late last week.

The adolescent brain is uniquely susceptible to nicotine addiction, says Dr. Gonzalez. “It has neurotoxic effects on the developing brain. In early adolescence, development of executive function and neuro-cognitive process in the brain has not fully matured.” Adolescents are more likely to engage in experimentation with substances such as cigarettes and Electronic Nicotine Delivery Systems (ENDS) and they are “more physiologically vulnerable to addiction,” the doctor continues.

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Dr. Martonito Estanislao, PPS-TCAG PRO, and the official rep of PPS at the Congress’ technical working group (TWG) wrote Gonzalez, “PPS with the Food and Drug Administration fought for 25 year old minimum age of purchase, but 21 years old prevailed.” Those present at the TWG also replaced “minor” in the bill with “young people.”

In a private message, Dr. Ulysses Dorotheo of the Southeast Asia Tobacco Control Alliance (SEATCA) remarksthat “They agreed to 21 as the minimum age because that’s also what they agreed on for the amendment to R.A. 9211 the Tobacco Regulation Act.”

 

The Healthier alternative?

Meantime, members of Philippine E-Cigarette Industry Association (PECIA)—said to be the country’s biggest vaping industry group—came in full force at both hearings at DOH and Congress. They consist of manufacturers of hardware and e-liquids, owners of vape shops, and importers and exporters who  attended the hearing to air the side of local manufacturers “We appeal to the government and regulators to assess carefully and hear all possible sides before coming up with any regulation,” says PECIA president Joey Dulay. “The industry is growing and a lot of our fellowmen also rely on this.”

PECIA is convinced that electronic cigarettes in the market present a viable option for Filipino smokers, and they are convince that they are less harmful to their health. Of late, heated tobacco 

products (HTPs) have been marketed worldwide, and touted as “novel reduced harm tobacco products by tobacco companies,” according to an assessment of industry data on Pulmonary and Immunosuppresive Effects of IQOS.

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Photograph from Horwin on Pixabay

Phillip Morris International submitted a “modified risk tobacco product (MTRP)” application to the FDA of the USA in 2016 purporting that its HTP product I-Quit-Ordinary-Smoking (IQOS) is “associated with reduced harm compared to conventional cigarettes.”

 

Further regulations

Proposed amendments to the bill include the following:

First off, there should be a total ban on advertising, except inside point-of-sale locations. The packaging of the e-juice should be “plain, without colorful pictures” these tend to attract kids who wish to try them “out of curiosity.”

Congressman Garcia says the packaging of e-cigarette products should contain appropriate health warnings, and disclose product ingredients and components, “and other specifications as may be directed by the FDA.”

There will be a total ban on sales to young people. As in Executive Order 26, point of sales of e-cigarettes should have a distance of (a minimum of) 100 meters from the perimeter of schools, public playgrounds, youth hostels, and recreational facilities.

One of the issues raised by PPS-Tobacco Control Group during the hearing in Congress was the need not just for designated smoking areas (DSAs), but designated vaping areas (DVAs) as well; and the need to protect children from second-hand aerosol (HSA) and third-hand aerosol (THA).

 

More considerations

Had the hearing not been adjourned posthaste, Estanislao would have raised the point of regulating flavors as an added measure to shield the children in the scenario of poor implementation of age sale restriction. He said that nicotine content and the amount of retail of e-juice will be taken up by the mother committee. He notes that the FDA raised the wide toxicity range of nicotine in various grades of preparation.

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Photograph from Sarah Johnson on Pixabay

Among the other matters that will be referred to the mother committee for resolution are the acknowledgment that these “alternatives” are not a harm-reduction tool due to the absence of conclusive scientific studies, and it should not be recommended as treatment product for tobacco dependence.

“Local government units should be given the power to regulate ENDS by enacting their respective ordinances, regulating or even banning their sale and use,” Garcia says, impassionedly. “This is in recognition of their police power under the general welfare clause and consistent with the devolution of health functions to the LGUs.”

 

For more on e-cigarettes, visit the Department of Health. You can see the transcript of the public consultation on the regulation of ENDS here.