Habit switching

Between public health (as represented by medical frontliners) and a powerful lobby, you can see whose interests prevail during election season.

With impressive speed, both chambers of Congress have passed the bill supposedly regulating vaping, but effectively allowing its wider use especially among the youth as it lowers the vaping age from the current 21 to 18.

Again with impressive speed and resolve, the House of Representatives, a.k.a. the HOR, overwhelmingly ratified the bicameral version of the bill last Thursday.

The lobbyists are surely ecstatic. Lawmakers ignored the strong opposition expressed by over 50 of the biggest medical organizations in the country plus the secretary of health himself against the Vaporized Nicotine Products Regulation Act.

The bill places e-cigarettes beyond the reach of health authorities, by classifying them as ordinary consumer products under the supervision of the Department of Trade and Industry instead of the Food and Drug Administration (FDA).

While everyone was preoccupied with battling an unprecedented pandemic – the worst crisis the country has faced since World War II – where the deadly culprit attacks the respiratory system, our self-serving legislators passed a law that promotes the use of substances that damage the lungs.

With nicotine in traditional cigarettes, it takes years of regular use before you die of lung cancer, COPD or chronic obstructive pulmonary disease (the third leading cause of death worldwide) and the other health problems aggravated by smoking, including stroke and heart failure.

In the case of e-cigarettes and vapes, death can come swiftly. The cases have been such that a medical term has been coined for the affliction: EVALI , or e-cigarette and vape-associated lung injury.

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In the United States, the Centers for Disease Control and Prevention recorded 2,807 hospitalizations with 68 deaths from EVALI in 29 states and the District of Columbia between August 2019 to Feb. 18, 2020 alone. The numbers don’t include non-hospitalized cases. The CDC reported that the median age of those hospitalized was 24 years.

And yet our lawmakers have chosen to swallow the sales pitch of the vape lobby, propounded by the tobacco industry that has been looking for ways to grow its business amid anti-smoking regulation in many countries: vaping encourages smokers to quit their habit.

Left unsaid is that it simply replaces one unhealthy habit with another – one which, as those EVALI deaths have shown, can be deadlier. And the risk vapes pose to public health will be around long after COVID has become endemic.

The World Health Organization has said in a report that the supposed scientific evidence for vaping’s effectiveness for quitting smoking is “scant and of low certainty.”

The medical groups that signed a letter against the bill include the Philippine College of Physicians, Philippine Medical Association, Philippine Pediatric Society, pulmonologists, cardiologists and surgeons. Shouldn’t their voices have prevailed instead of the vape lobby?

There must have been multimillion persuasive reasons for the voices of the medical community to be ignored by Congress.

Sen. Ralph Recto, principal author of the measure in his chamber, is particularly disappointing. You’d think he would have known better than the HOR members.

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In August 2019, Finance Assistant Secretary Tony Lambino had to cut short a study program at Harvard University and return to the Philippines after his right eye was paralyzed.

The doctor in Boston told him the cranial nerve 3 palsy was likely caused by his recent switch from cigarettes to Juul flavored vape pods. The top investor in Juul Labs is Marlboro maker Altria. Upon Tony’s return to Manila, a doctor gave him the same diagnosis. He had to wear an eye patch like a pirate for several months, until the paralysis ended.

It would be ironic if the vape bill would be signed into law during the presidency of a man who had won on a platform of eliminating the illegal drug scourge.

Many vapes contain THC or tetrahydrocannabinol, the mind-altering compound that gives the high in marijuana. This risk may be brushed aside by those who are dreaming that we will follow the lead of Thailand, which has become the first country in Southeast Asia to legalize home cultivation of marijuana.

But in the Philippines, mere possession of just 500 grams of marijuana can put you away for life, and earn you a fine of P500,000 to P10 million.

When vaping, liquid is heated in the e-cigarette to produce aerosol that is inhaled to the lungs. Apart from THC and nicotine, the liquid can contain cannabidiol or CBD oil, another active ingredient in marijuana. Philippine law allows CBD oil importation for medical compassionate use as a chronic pain reliever, but the rules are stringent, with FDA approval needed.

Then there’s Vitamin E acetate, used as an additive especially in THC-containing vapes. While Vitamin E acetate can be harmless as part of a food supplement or for skin creams, it can cause lung damage when inhaled, according to the CDC, and is seen as a culprit behind EVALI lung damage and death.

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Here are two of the CDC recommendations, from its website:

• E-cigarette, or vaping, products (nicotine- or THC-containing) should never be used by youths, young adults, or women who are pregnant.

• Adults who do not currently use tobacco products should not start using e-cigarette, or vaping, products.

Malacañang has promised a thorough review of the bill submitted by Congress for President Duterte’s signature.

The President has been widely hailed for imposing a nationwide smoking and vaping ban in public conveyances and enclosed public spaces. He also banned the manufacture, distribution, marketing and sale of e-cigarettes not registered with the FDA.

Duterte’s Barrett’s esophagus and the painful Buerger’s Disease must have raised his awareness of the health risks posed by smoking.

Perhaps he can be more resistant to the powerful vape lobby. Even if it’s election season.