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Philippines: 22-year old’s senseless death while denials on vape harms persist

24 June 2024

A healthy, sporty, 22-year old Filipino male died from a heart attack. He had no risk factors except that he had been vaping for the past two years before he had the heart attack. According to a doctor from the Philippine Paediatric Society Tobacco and Nicotine Control Advocacy Group, “his clear lungs were erased because they were blocked by the vape chemicals.” It is a senseless death, a young life snuffed out.

This case was the only death among the six recorded EVALI (e-cigarette or vaping-use associated lung injury) cases as of May 2024 in the Philippines reported by the Department of Health. 

Elsewhere in ASEAN, up till December 2023, the Malaysian Ministry of Health has recorded 14 cases of EVALI involving of vapers aged 30 to 35. In Thailand, where e-cigarettes are banned, the first confirmed case of EVALI was recorded in October 2022. The young patient (20-30 years) was admitted to the hospital after he began vomiting and having difficulty breathing, according to the Chief of the Internal Medicine Division at Ramathibodi Hospital.

In the USA which had started documenting EVALI cases much earlier, the Centers for Disease Control and Prevention (CDC) confirmed2,807 cases of EVALI and recorded  68 deaths attributed to that condition in February 2020.

More and more evidence on the harms of vaping are emerging: vaping damages the lungs, increases risk of cardiovascular morbidity and mortality, impacts adolescent brain, affects mental health, causes increased risk of strokes, immediate nicotine toxicity, and a host of other ailments and harms. 

In Malaysia, the National Poison Centre (NPC) recorded a five-fold increase in poisoning cases due to e-cigarettes exposure in 2023. According to the NPC, a total of 111 cases were referred to their call centre in the last nine years. Most of the cases involved children below the age of 5 years. Between 2022 and 2023, there was a change in the age trend, where more teenagers aged 15 to 19 yearsexperienced poisoning due to the deliberate use of e-cigarettes.

Despite overwhelming evidence on the dangers of vaping and its nasty outcome, tobacco harm reduction proponents and tobacco industry front groups continue to spew the “95% safer” myth, and lobby or justify to policy makers, medical professionals and the public to accept e-cigarettes.

Clarissa Virgino, the Filipino representative of the front group CAPHRA (the Coalition for AP Harm Reduction Advocates), appears on multiple forums to champion vaping while simultaneously challenging evidence and advocates who raise the harms associated with it. Her response to the death of the young Filipino, “… easy to conclude that vaping is the primary cause of death. I’m no doctor but the angle being taken and inferred is skewed to make it appear that vaping is deadly.”

A Singapore academic, Associate Prof Jeremy Lim, from the National University of Singapore called for the industry to work with regulators, which would be a violation of WHO FCTC Article 5.3, at a tobacco and nicotine industry sponsored conference GTNF (Global Tobacco and Nicotine Forum) in 2023.

Thai tobacco harm reduction advocate Asa Saligupta, a regular speaker at industry sponsored events such as the Philip Morris sponsored (via KAC) Global Forum on Nicotine 2024 is lobbying to reverse Thailand’s ban on e-cigarettes. He is the Director of ENDS Cigarette Smoke Thailand Tobacco Smoke Free (ECST) and organized the “Clear Lungs, No Tar” activity despite what the evidence shows about the harmful effect of vaping on the lungs. He is also the winner of INNCO (which is funded by Philip Morris) Members’ Advocate of the Year 2022. See here for more information on harm reduction, front groups and electronic smoking devices.

They got lips? We want them.” This was RJ Reynold’s response in 1990 to which young people they were targeting — junior high kids or even younger? More than 30 years later, the tobacco industry continues to target children to secure lifelong customers.

A study by the Institute for Global Tobacco Control (IGTC) at Johns Hopkins Bloomberg School of Health found ongoing sales and advertising of tobacco products near many schools in the Philippines. It identified at least 43 e-cigarette and 33 Heated Tobacco Product (HTP) retailers near various schools in selected cities and regions. The IGTC researchers pointed out that marketing strategies at points of sale, like displays and advertisements for cigarettes, e-cigarettes, and HTPs, are aimed at Filipino youth.

Children 13-15 years old are using e-cigarettes at rates higher than adults in all WHO regions. More than 12% of teenagers in Indonesia and 35% in Malaysia purchased e-cigarettes from shops, kiosks or shopping malls. More than 56% of children from Indonesia and 63% from Vietnam purchased them from “someone else”.

According to the Health Promotion Bureau of the Philippines Department of Health, the prevalence of e-cigarettes use especially among Filipino youth has increased 110% increase in just four years, from 11.7% in 2015 to 24.6% in 2019.

The e-cigarettes situation has gotten out of hand. Best practice is to ban them.