When sin taxes on tobacco and alcohol were introduced in the Philippines, there were high hopes they would bring about benefits for health. The taxes on tobacco products, which have been increasing each year, were supposed to reduce tobacco use, while the tax revenues could be used for public health, including information and education about the risks of tobacco use, smoking cessation programs and other measures to reduce problems associated with smoking.
For the first half of 2018 alone, revenues from tobacco taxes reached P78 billion. That’s larger than the P72-billion total budget of the Department of Health for 2018. So much can be done with those taxes, but I don’t see substantial efforts to meet the many challenges of tobacco use.
This includes the most basic education about the dangers of smoking. For years now, we’ve seen only fear-based campaigns about the risk of lung cancer from smoking. Little has been said about the many other problems, some more serious than lung cancer, including cardiovascular diseases, emphysema and a host of other diseases. Graphic warnings on cigarette packs do describe these risks, all the way up to impotence, but they seem to have little impact.
And while we still have to tackle the problems of smoking, we have a new related problem that’s getting little attention: vaping.
Also known as e-cigarettes, vaping involves the use of a device, loaded with cartridges containing e-liquid, to replace smoking. The term vaping comes from the device’s use of vapor, water interacting with various chemicals to deliver the e-liquid.
The e-cigarettes have been praised as a safer substitute for smoking, especially because they do not have the toxic substances inhaled through cigarette smoking.
What people often don’t realize is that most of the e-liquids contain nicotine, which is what creates the addiction to tobacco. There’s concern over the effects of nicotine, which is a stimulant, on the brains of children and young adults. A statement from the Forum of International Respiratory Societies in 2014 also notes: “If exposed to nicotine during pregnancy, a child may have an increased risk later in life of type 2 diabetes, obesity, hypertension, neurobehavioral defects, respiratory dysfunction, and infertility.”
We should be most worried about vaping’s attraction among young people, with an entire culture developing around its use. Visit the site for “Blu,” one of the most popular vaping companies, and you will find colorful descriptions of different types of vapers: “flavorists” who are described almost like connoisseurs in taste, “tricksters” who can blow smoke rings, “mentors” who are veterans in using the different e-liquids.
The allure of vaping overlaps too closely with that of smoking. Add on the addictive potential of nicotine, and you can see the high risk of young people moving from vaping to smoking.
I’m concerned, too, with the way the e-liquids can be deceptive with its flavors, such as pistachio sundae, exotic mango, coffee orgy and even Shirota Yakult. I have heard young people saying these are all nicotine-free (like bubble gum, my 12-year-old son says, because there are bubble gum-flavored e-liquids). While there are indeed e-liquids that have 0-percent nicotine, you won’t know either, because the e-liquids that carry nicotine will vary from 3 mg/100 ml to 18 mg/100 ml, the upper figure being equivalent to a strong cigarette.
Some products will have, on their labels and website ads, figures indicating “mg,” but they don’t indicate that the “mg” refers to nicotine. And even if they did, many people wouldn’t know what nicotine is anyway, or would associate it only with cigarettes.
Just last August, the US Food and Drug Administration finally cracked down on vape manufacturers, calling on them to prove that their products cannot be accessed by minors. This is why the website of “Blu” does contain, in bold letters: “Warning: This product contains nicotine. Nicotine is an addictive chemical.”
Yet all you need to do is click a button to say you are of legal age, and you can enter the site and order stuff.
It’s worse in the Philippines, where you can buy the products on Lazada, or straight from vape dealers, just as with cigarettes.
Vaping is too new to establish its many other risks. The liquid is not just water, but contains other chemicals to create more vapor, and a “smooth” taste. The flavorings, even without nicotine, are artificial chemicals with ingredients that are not going to appear on the label. Many of the vape products come in from China, which has lax regulations on product labeling, if not consumer protection in general.
Let’s not wait for vaping problems to become another epidemic like that of cigarette smoking.
mtan@inquirer.com.ph