(Second of a series)
In the middle of a deadly health crisis, the tobacco industry scored a win in the country, sticking to a tried and tested playbook to protect its interests.
Despite medical experts’ warning against the risks to health of vapes and other novel tobacco products, Congress passed a piece of legislation favoring the industry while undermining and contradicting public health protection.
Industry-friendly lawmakers, on the other hand, describe it as a measure to protect and promote the people’s right to health.
The proposed Vaporized Nicotine and Non-Nicotine Products Regulation Act allows persons 18 years old and above to buy and use electronic cigarettes and heated tobacco products (HTPs). It is more liberal than the existing law, where the age of access is 21 years old, and allows online promotion of the products that can now be offered in different flavors.
And instead of being under the jurisdiction of the Food and Drug Administration (FDA), the products will be regulated by the Department of Trade and Industry (DTI), a provision that Sen. Pia Cayetano slammed. “What business does the DTI have to regulate health? What experience does it have?” she asked. “They are not vanguards of health.”
She expressed her dismay on Dec. 16, 2021, when the Senate overwhelmingly approved on final reading the bill regulating the novel products. She was one of only two senators who opposed the measure.
Seven months prior, the House of Representatives passed its own version, which was co-authored by 154 legislators. On final voting, it drew the support of 192 out of 300 representatives.
Rep. Angelina “Helen” Tan, chair of the House committee on health, said the bill “pretends to be a health measure for all but only gives primordial consideration to trade and commercial interests of the few.”
The consolidated measure -- the Vaporized Nicotine and Non-Nicotine Production Regulation Act – was ratified by the two houses of Congress in January.
Health and medical authorities, including those from the government, denounced the legislators’ disregard for the expert knowledge they shared during hearings. Their inputs were not considered at all. “Zero. Nothing.”
That is how one tobacco control advocate described how congressmen regarded the inputs from the health sector, choosing instead to cling to the tobacco industry.
Medical experts were alarmed at what seemed like a rush to pass the bill at a time doctors were busy fighting COVID-19, and could only conclude that the piece of legislation was a product of the tobacco industry’s interference.
The new bill hijacks provisions of Republic Act No. 11467, which increases the excise tax on alcohol products, e-cigarettes and HTPs, and assigns the regulation of novel tobacco products to the FDA. The measure is due for full enforcement this May.
Former FDA director general Eric Domingo says the new bill was not a total surprise and showed the industry’s strong resistance to any move that would go against its gameplan.
“We could see it coming. They’ve been working on it for quite some time, and we’ve been working against it.”
Domingo recalls the time the FDA was taken to court to stop it from regulating vapor products. “Every time the Department of Health (DOH) or the FDA does anything to try to regulate these products, there is very strong resistance.”
Legal challenges are part of the industry’s game plan to protect and preserve its turf.
Resisting government-imposed tobacco regulations is one thing; using intimidation and physical threats against anti-tobacco advocates is another.
Dr. Rizalina Gonzalez, chair of the Philippine Pediatric Society-Tobacco Control Advocacy Group, relates an incident that took place in 2019 involving her son and suspects it had to do with her strong stance against these vapor products.
“My son used my car and, thinking it was my car, did you know that a hole was punched into the tire?” she says in an interview with VERA Files. “Then he also received messages on Viber saying ‘tell your mom she’s a bitch’.”
She could not, however, tell for sure who the source of the threats were.
An outspoken critic of novel tobacco products, Gonzalez felt threatened after that incident. “Since then, whenever I have a speaking engagement, I always ask for police (assistance) because they might harm me,” she says.
Corporate social responsibility
On May 15, 2020, or two months after COVID-19 was declared a pandemic by the World Health Organization, Health Secretary Francisco Duque III issued a memorandum spelling out guidelines on tobacco control in light of the health emergency.
He warned against the detrimental effects of tobacco products and called for restrictions on their use as the country reported dozens of cases of infection and a few deaths. “As the body’s immune system and respiratory systems are weakened from toxic substances in the process of burning and/or heating tobacco and tobacco-related products, people are at increased risk of contracting COVID-19 and having a more severe form of illness, and may even result in death.”
At least 87, 600 Filipinos die each year (240 deaths every day) from tobacco-related diseases, according to the DOH.
Equally noteworthy in Duque’s memorandum was a reminder to public officials and employees that unnecessary interaction with the tobacco industry is prohibited and that they are barred from soliciting and/or accepting gifts or favors from people related to the tobacco industry in the course of their official duties.
These prohibitions are stipulated in the joint memorandum circular (JMC) between the DOH and the Civil Service Commission (CSC) aimed at protecting the bureaucracy against tobacco industry interference, referring to a broad array of strategies and tactics employed by the industry to derail or elude government regulations on tobacco control.
Duque’s memorandum followed reports that tobacco companies were handing out food, rapid test kits, personal protective equipment to some local government units (LGUs) and donating ventilators and ambulances to others under their corporate social responsibility (CSR) program.
The Philippine Army was among the first beneficiaries of the industry’s CSR initiatives, receiving two ambulances from the Lucio Tan Group and the Jaime V. Ongpin Foundation Inc (JVOFI). The two also donated a ventilator, polymerase chain reaction machines to hospitals outside the capital, as well as food packs, alcohol and other medical supplies to LGUs.
The Lucio Tan Group owns Fortune Tobacco, the local partner of tobacco giant Philip Morris International.
VERA Files reached out to PMFTC, Inc., the Philippine affiliate of Philip Morris International, for its side of the story. The company, which controls over 90% of the local market, declined our requests for an interview and reply to a set of questions sent through its head of communications.
According to the Global Tobacco Industry Interference Index 2020, the industry stepped up CSR activities during the pandemic, capitalizing on the vulnerability of governments facing a shortage of resources during the health crisis.
It said the industry also sought to undermine the leadership role of the health agencies in tobacco control by shifting decision-making to the non-health sector. In the Philippines, this is best seen in how legislators pushed for the trade department to regulate the novel tobacco products.
There aren’t many new tactics to influence policy making and legislation in relation to conventional and novel tobacco products, but only a leveling up of old ones because of the pandemic, according to Dr. Ulysses Dorotheo, executive director of the Southeast Asian Tobacco Control Alliance (SEATCA).
“Support through CRS was not done on a very wide scale then. This is something that has been stepped up. What we saw in our monitoring was last year (2020), the amount donated by Philip Morris (to the private sector) was times four compared to the previous year,” he says in an interview with VERA Files.
PMI spent $13.405 million on 12 projects in 2020, compared to $2.928 million in 2019. It gave the bulk of this amount to JVOFI, according to a SEATCA report on tobacco advertising, promotion and sponsorship.
A PMI report said funds coursed through JVOFI in 2020 were mostly for social welfare and COVID-19 assistance programs.
“(What) is really prominent now is their use of science, their exploitation of science. This is a very old tactic that came about since the 1950s in the U.S.,” Dorotheo adds, referring to a time when studies found a link between smoking and cancer, yet the industry said the evidence was not real and still unproven.
It was then that tobacco companies acted collectively and established the Tobacco Industry Research Council, whose aim was to assure the public that it was addressing the concerns about the safety of their products.
But instead of supporting genuine scientific research, it publicized research purporting to prove that tobacco did not cause cancer to deliberately confuse the public about the risks of smoking, according to a bulletin of the World Health Organization (WHO) in year 2000 that looked back at the industry’s record of strategies and tactics to resist public policy on health.
“The industry’s strategy does not require winning debates [that] it manufactures. It is enough to foster and perpetuate the illusion of controversy in order to muddy the waters around scientific findings that threaten the industry,” the report says.
Decades later, the industry is using the same playbook to promote a new set of products while continuing to resist government measures to control tobacco use. Cayetano calls these vape products as the industry’s new frontier.
According to a July 2017 report by global news agency Reuters, Philip Morris targets the WHO-FCTC conferences where new tobacco control measures are negotiated, and also intervenes at the country level where treaty delegates are picked and tobacco control rules are enacted.
At the ninth session of the Conference of the Parties (COP9) to the WHO Framework Convention on Tobacco Control (FCTC) last November, Foreign Affairs Secretary Teodoro Locsin, Jr. expressed all-out support for the tobacco industry.
One of the 10 co-heads of the Philippine delegation, Locsin described tobacco as useful and beneficial because “taxes on a vice are called salutary.” He praised the industry for developing products that “deliver similar satisfaction with far less harm.”
The health department repudiated the statement, saying it negates the very principles of the global treaty and reiterated the agency’s stand that “there is no good in tobacco.”
Refuting the claim that taxes fund public health initiatives, the DOH cited that in 2011, the estimated cost of tobacco-related diseases totalled P177 billion, almost seven times higher than taxes collected from tobacco products that year amounting to P24.9 billion.
Another unpleasant surprise was the composition of the delegation. It had 52 members, including officials from the trade and industry department. There were 10 co-heads, one of whom was a legislator representing a tobacco-growing province. A medical expert known for her tobacco control stance was apparently edged out in favor of the congressman.
Hijacking ‘harm reduction’
After acknowledging the harm in cigarette smoking, the industry is now offering e-cigarettes and heated tobacco products as less harmful compared to conventional cigarettes. The industry boasts of a research facility in Switzerland where its products are thoroughly studied to make sure they are less harmful.
Dorotheo, a health advocate for more than two decades, said the industry is now “leveraging the disagreement in the scientific community about how safe or harmful these novel products are ... to widen, to create a rift in the community.”
“The reason the tobacco control community has been so successful in the past is we spoke with a united voice. But now it is fractured on the issue of e-cigarettes.”
He says there are genuine tobacco control advocates who support e-cigarettes. “Now they are saying ‘we have the evidence and you are disregarding the evidence and you’re actually on a witch hunt to crucify the industry even though we are promoting harm reduction’.”
This narrative is now the mantra of vapers, consumer groups and even a handful of medical practitioners who are adopting the industry’s position.
A few doctors have turned the argument upside down by declaring that the vape bill is a big win for public health.
“Cigarette is the product that is causing all these deaths, and any way we can make smokers stop using cigarettes will put smokers in a better place,” says Dr. Rafael Castillo, a cardiologist and a council member of the International Society of Hypertension.
The best way to save smokers, he says, is by offering them less harmful alternatives.
“The science has become extremely strong in recent years that e-cigarettes are less harmful than conventional cigarettes,” says Dr. Fernando Fernandez, secretary-general of Asia Pacific Dental Federation.
Harm reduction is a strategy under the international treaty to reduce tobacco use and when it was proposed, Dorotheo explained, electronic cigarettes were not yet what they are now. They were not yet in the market so nobody had an idea about e-cigarettes as harm reduction, he adds.
“What was discussed as harm reduction was to reduce the content of nicotine in cigarettes so that it will be less addictive. And by having people less addicted to cigarettes, they will be smoking less and therefore be healthier,” the tobacco control advocate says. “The concept of harm reduction, unlike now, was totally different.”
For Rep. Rozzano Rufino Biazon, one of a few health champions in Congress, it is important for policy formation to be insulated from tobacco industry influence but he acknowledges that balancing two conflicting interests – health and profit — is problematic.
“But it should be a no-brainer for us. The bias should be towards the health of the people. Why can’t we have the same objective or policy direction for tobacco use as we have in illegal drugs? With illegal drugs, we say completely, ‘no’,” he said in an online forum organized by non-profit ImagineLaw last May.
Several months later, and in the face of a pandemic, public health suffered a double whammy.
(VERA Files is put out by veteran journalists taking a deeper look at current issues. Vera is Latin for “true.”)
This story is part of the project Seeing Through the Smoke, which is supported by a grant from the International Union of Tuberculosis and Lung Disease (The Union) on behalf of STOP, a global tobacco industry watchdog.