NON-COMBUSTIBLE alternatives like vapes and heated tobacco products (HTPs) are practical solutions to cigarette smoking epidemic, the world’s leading cause of preventable death and diseases, said a respected family doctor and tobacco harm reduction (THR) advocate.

Dr. Lorenzo Mata, president of Quit For Good, a non-stock, non-profit organization that advocates real, practical, and tangible solutions to the smoking problem, said the traditional "Quit or Die" approach is not working to substantially reduce the risk of death and disease from smoking.

“In our country, there are almost 17 million smokers. And a shocking rate of more than 117,000 Filipinos die each year due to tobacco smoking. Equally alarming is the measly quit rate of 4-percent measured as of 2015 which largely remained unchanged from 2009,” he noted during the 4th Asia Harm Reduction Forum held virtually on June 28, 2021.

He recommended that another option must be provided to adult smokers who do not wish to quit.

“Tobacco harm reduction, through the use and promotion of safer alternatives to combustible tobacco, should be employed to substantially reduce the risk of death and disease of smoking,” Mata said.

THR is defined by the 2021 Global State of Tobacco Harm Reduction report as “a range of pragmatic policies, regulations and actions which either reduce health risks by providing safer forms of products or substances or encourage less risky behaviors.”

Mata identified innovative electronic nicotine delivery systems that eliminate the combustion process, such as heated tobacco products and e-cigarettes or vapes, as examples of THR.

“Beyond any reasonable doubt, vaping is considerably less harmful than combustible cigarettes. Almost all the harm done by cigarettes arises from the smoke which is caused by combustion. Vaping does not produce smoke—only vapor,” he said.

“What happens in smoking combustible tobacco is a chemical change. What happens in vaping is a physical change,” he said.

“In chemical change, this is brought about by extreme heat or combustion that causes oxidation of the original substance which then creates different chemical substances. The byproduct of oxidation is already totally different from the original substance. That is why from tobacco, it now comes out as smoke containing harmful substances where hundreds are toxic,” he further explained.

“When it comes to vaping, you just heat the liquid until it vaporizes. When you create vapor, you don’t change the original substance to a different one. This, my friends, makes a lot of difference in public health,” Mata said.

The doctor said another alternative to cigarette, which has no combustion, are HTPs.

“Similar to e-cigarettes, there is no burning. But unlike vapes, nicotine is naturally found in the tobacco. By heating the tobacco without burning it, HTPs only produce vapor,” he said.

“Vapor products and HTPs are not completely risk-free but they only carry a small fraction of the risk of cigarettes. Allow me to remind everyone, however, that the best way to avoid the harms of cigarette smoking is as simple as quitting completely,” Mata said.

Citing the conclusion of a 2021 Toxicology Report Journal review from the University of Occupational and Environmental Health in Japan, Mata said the “use of electronic cigarettes and heated tobacco products could lead to a significant reduction in exposure to harmful substances compared to combusted cigarettes.”

“These are just some of the many scientific studies supporting the less-harmful claims regarding electronic vaping products. The bottom line is this: the deadly effect of cigarette smoking is due to combustion of tobacco that produces smoke which contains carbon monoxide and more than 7,000 chemicals,” he said.

Mata said this means that vaping clearly is a viable alternative to cigarette smoking.

“In line with this, we urge the government to consider the best possible differentiated legal framework through careful review of the science and evidence presented on the matter, and defend the right of the consumers to make better choices for themselves,” he said.

He said, “the considerably less harmful products should not be taken off the shelves while the very much harmful product remains easily accessible and that the harm reduction potential of electronic vapor products should be maximized instead and regulated to minimize the risk to the youth and the non-smokers.”

The Asia Harm Reduction Forum is a non-profit and interdisciplinary organization that advances public health education for the improvement of lives and environments across the globe. It is an international avenue for experts, academics, and advocates to share and exchange research findings, product developments, and pragmatic solutions on tobacco harm reduction.