PHILTHRA urges harm reduction: Studies back lower-risk nicotine products

MANILA, Philippines — Citing studies that suggest lower risks from nicotine products other than traditional cigarettes, the Philippine Tobacco Harm Reduction Advocates (PHILTHRA) identified e-cigarettes, heated tobacco products and nicotine pouches as less harmful alternatives for smokers who switch completely, based on what it described as current scientific evidence.

PHILTHRA convened the 2nd National Summit on Nicotine and Harm Reduction in Pasay City to discuss policies concerning cigarettes and smokefree nicotine products. Participants emphasized that taxes on smokefree alternatives should not be set at the same level as those on combustible cigarettes, particularly if the goal is to encourage adult smokers to switch to less harmful options.

PHILTHRA presented findings from meta-analyses and a scoping review conducted by CAPS and Partners Inc. One meta-analysis, which examined nearly 300 peer-reviewed studies, reported that harmful and potentially harmful constituents in vape aerosol were reduced by at least 90% compared with cigarette smoke, while its toxic potency was lowered by 85% to 95%.

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READ: How flavors, social media draw Filipino youth to vaping

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In another review of 20 studies, researchers found that users of alternative vape delivery systems experienced reductions in biomarkers of up to 97%, while four studies indicated no significant changes.

PHILTHRA reported that its scoping study of 670 papers, conducted over the past three months, yielded two consistent conclusions. It said that while noncombustible nicotine products are not risk-free, they are less harmful than combustible cigarettes. The group intends to expand this work into a meta-analysis.

The group argued that the government has a responsibility to provide smokers with less harmful alternatives. It added that while individuals will continue to choose risky products based on their own notions of happiness, the state must still safeguard their well-being.

“The State still has the duty to protect them. And the way to protect them is to give them the less harmful alternative,” PHILTHRA said.

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PHILTHRA challenged two assumptions it attributed to Department of Finance (DOF) policy: that all nicotine products are equally harmful and that illicit trade is unaffected by tax rates. On the first point, the group argued that available evidence does not support treating all nicotine products as equally harmful.

The group said around 90 countries permit and regulate the sale of alternative nicotine delivery products. PHILTHRA added that some nations that initially banned these products have since shifted toward regulatory frameworks.

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It also said the number of Middle Eastern countries maintaining bans has declined from eight to four. The group cited Saudi Arabia and the United Arab Emirates as having lifted bans in 2019, Jordan as having authorized regulation that year, Bahrain as having adopted technical rules in 2021, Malaysia as having reclassified vape liquids, Egypt as having replaced its commercial ban with taxation and quality standards, and Canada as having allowed legal commercial sales.

PHILTHRA argued that banning products instead of regulating them exposes consumers to substandard goods, underscoring the need for proper oversight. “When you ban and you don’t regulate, you don’t protect the consumers,” the group said.

READ: FDA announces first OK of fruit-flavored e-cigarettes for adults

PHILTHRA noted that the Philippines, through Republic Act No. 11900, has incorporated harm reduction into law, which the group compared with Sweden’s approach. The group added that countries such as the United Kingdom, New Zealand and Canada have adopted public health strategies centered on switching. It emphasized that nations moving away from prohibition generally establish controlled legal access rather than deregulation.

The group also urged the adoption of risk-based taxation for nicotine products and called for stronger measures to combat illicit trade.

“It is in the interest of the state to protect the legitimate market,” PHILTHRA said, adding that the government cannot overlook the impact of tax policy on the size of the illicit market, which it said could either shrink or expand depending on the policy.

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Summit conveners introduced the Philippine Harm Reduction Agenda, a science-based, risk-proportionate framework designed for national policymakers. They announced plans to submit it to Congress and the DOF.