MANILA — In April 2019, medical anthropologist Michael Tan received a bizarre email.
The sender is a woman, who introduced herself as someone who used to work with the World Health Organization (WHO), Department of Health (DOH), and United Nations Children's Fund (UNICEF) in promoting breastfeeding.
The subject of her email, however, came as a shock and disappointment for Tan.
"Medyo na-sad ako kasi dating health advocate siya eh, she was promoting breastfeeding, and then she’s gone into this," Tan told ABS-CBN News.
The woman was now working for a Nevada-based consulting firm representing an American electronic cigarette (e-cigarette) company that makes ultra-trendy, uber-sleek vaping device popular among the youth. The company has been accused by US media of creating a "teen vaping epidemic."
In an email to Tan, she cited how the e-cigarette company her firm represents aims "to help over 1 billion adult smokers around the world to stop smoking tobacco cigarettes."
She was urging the medical anthropologist to "write a follow-up piece given developments" on e-cigarette studies worldwide. At that time, Tan was chancellor of University of the Philippines Diliman, and is known for his "Pinoy Kasi" column published by a major Philippine broadsheet.
"E-cigarettes can help reduce smoking-related illnesses and relieve UHC so funds can be directed towards other concerns like maternal health care, infant and child care... This will certainly help the over 16 million Filipino smokers who want to quit smoking," she pitched to Tan.
But Tan was nowhere near sold to the idea. In fact, he said, the offer was nothing but an illustration of how e-cigarette companies employ "devious ways" to legitimize their smoking cessation "advocacy."
"She presented herself as trying to help young people with smoking cessation. But the thing is, young people would not have started, 'yan ang punto din eh. And they are using e-cigarettes to get people hooked. That is what is so horrible," Tan said.
INITIATION AND SALVATION
"Mela," 21, still remembered how she was introduced to her first yosi, the Filipino street term for traditional cigarettes.
"Fifteen ako, sinubukan namin ng friends ko mag-yosi, ganon lang," Mela (not her real name) told ABS-CBN News.
Before she knew it, she was addicted.
Mela's initiation to the vice was in no way unique; it was a common experience shared by millions of smokers around the world.
In the Philippines, "smoking kills 240 Filipinos every day," the WHO estimated in 2017. Mela did not want to be one of those casualties.
Mela, then 19, tried e-cigarettes, the "safer" alternative to tobacco smoking, she was told.
For over a year, she tried to stick to e-cigarettes, and along the way got introduced to groups who shared a "passion" for the same smoking device.
"I had intended to try it and maybe try sticking with it kasi mas mababa daw 'yung tar and burned chemicals, kahit same nicotine lang... But it didn't agree with my habits kaya I let it go slowly," Mela said.
Mela also discovered studies that questioned the effectiveness of vaping as a way out of smoking.
However, she recounted how her ties with her "vaping friends" prevented her from giving up the device sooner despite learning about its alleged ill effects.
"[T]hey are tied together by a common passion and do not really require much effort to grow... And the different modifications and customizations, I feel, make it suited to be made into a hobby," Dr. Angel Dealino, who did an ethnographic research on young vapers during her graduate studies at the UP College of Medicine, told ABS-CBN News.
Most of her research subjects belong to low-middle to middle class, or those who can afford to buy e-cigarettes.
"One of the themes that became apparent during my time with them was their strong sense of kinship or barkadahan, more so in the younger vapers. They would go to vaping events together, hang out in the vape shop or lounge, and even join or watch vaping contests," Dealino said.
While it appears harmless, Tan, who is also a medical anthropologist, suggested that this multi-sensory experience was designed as a hook and "staging area" for a community to blossom.
"It’s creating a sensory stage for it. May staging area for the community. And it has to appeal to all the senses, even the smell that’s why all the flavors are important, and then the visual compartment... That’s where you get all the other stimuli so it becomes a package deal," he said.
"It’s so devious because — yes it’s cleaner in the sense that they took out a lot of the garbage [from e-cigarettes] — but it’s also more theatrical... It’s theater eh, you watch these guys, they’re blowing billows of smoke, and that is part of the charm," Tan added.
But apart from the design, could this visually charming element of vaping be part of a larger business strategy to target young people?
"That was part of the strategy, the corporate strategy. I have no proof, of course, that they’re trying to build a community, but it’s very clear that that is what happened," Tan speculated.
The medical anthropologist traced this desire to be part of a community, the Philippines being an agrarian society.
"Kasi were still basically an agrarian society, agricultural community... Because in agriculture kailangan sumasama ang mga tao, the bayanihan thing, people help each other all the time, so the emphasis always is on group activities and communalism. So kahit sa siyudad na tayo, nandyan pa rin 'yung ethos natin na still very communal," he said.
ARE THESE COMMUNITIES GOOD OR BAD?
Tan argued that these vaping communities could be weaponized to promote or perpetuate negative behaviors.
"These vaping communities I think is the most obscene, it is terrible, to use communities. They are riding on youth culture. It’s particularly devious in the Philippines na napaka-susceptible ng kabataan natin, especially when you layer vaping over the sense of community," he said.
It was the barkadas that give meaning to the experience, he said, and without them, letting go of vaping would have been easier.
"Walang kahulugan 'yan kung walang barkada eh. It’s the barkada that says, 'wow ang sarap grabe oh, ay ang ganda nito.' It’s the community that gives it meaning, 'may kahulugan ito para sa atin.' It’s a shared joy,” Tan said.
But Quit For Good, a non-profit organization that advocates for sustainable ways to quit tobacco use, cautioned against demonizing e-cigarettes, which they view as a legitimate transition device leading ultimately to smoking cessation.
"These are the very same kids who otherwise would be prone to or are inclined to venture into smoking sooner or later in their life. So to be afforded now of a much less harmful alternative could only be a good thing to them," Quit For Good president Dr. Lorenzo Mata told ABS-CBN News.
For Mata, barkadahan over vapes is "less harmful" compared to other inclinations the youth are into such as "drugs, sex, pornography, violence of any kind, and alcohol."
"These are among the many kicks they wanted to get involved with during this stage of adventurism. So to be geared to a less harmful activity is much better than any of the above-mentioned undesirable activities."
He likewise defended vape designs as a product of its time, as opposed to criticisms that manufacturers were intentionally appealing to youth sensibilities.
"It is attractive because of the design and the flavors but this was not, as wrongly claimed, targeted to the youth. A sleek and high-tech in design and why should not it be? We are now living in a techie world," Mata said.
VAPE & BARKADA: A LETHAL COMBO?
Mata also rejected notions that companies may have been behind these vaping communities.
"The 'vaping communities' sprouted on their own, motivated mostly by their desire to get out from the clutches of smoking... Some companies may have been a bit aggressive but the development of this sector of society, the vaper communities, would still have flourished as it is now, whether there was corporate influence if any or there was none," Mata said.
Dealino, the doctor who did the ethnographic study on young vapers, had a similar conclusion.
"At least for the group that I was able to observe, there was no direct corporate strategy that was in play. They were simply young low-middle class vapers who came together over a common interest. My experience, however, may not reflect the more macro- level that could be targeted by corporate strategies," she said.
Corporate sanctioned or not, Tan believes that the Filipinos' cultural structures are working against itself when it comes to quitting a vicious habit, like smoking.
"When you talk about vaping, you add on the community as a cue, that is the worst thing. May sensory na, plus the community, so when you have the withdrawal, you will not be missing the nicotine alone, but missing the company as well lalo na para sa Pilipino because we're so barkada-oriented, we live for the barkada eh," Tan said.
This story was produced under the "Nagbabagang Kuwento Media Fellowship Program Cycle 4" by Probe Media Foundation Inc. (PMFI) and Campaign for Tobacco Free Kids (CFTFK).