Action on Smoking and Health Philippines Executive Director and National Secretary of Philippine College of Physicians Dr. Maria Encarnita B. Limpin reiterated that vaping and e-cigarette products are not safe alternatives for tobacco.

“E-cigarettes and HTPs [Heated Tobacco Products] are not recommended alternatives for smoking, there is still no true scientific evidence that it is not harmful. The fact that e-cigarettes have a tendency to explode makes it as dangerous – if not more dangerous – than traditional cigarettes. Moreover, there are several cases and reports that show these products causes diseases for the heart and lungs. It is not a safe product,” said Limpin.

Limpin also noted that some smokers do not merely switch from cigarettes to e-cigarettes as there is also dual use of e-cigarettes.

“The evidence showed that more than fifty percent of those who use vape still continue to smoke conventional cigarettes,” said Limpin.

Studies have shown that e-cigarettes deliver lower levels of plasma nicotine compared to conventional cigarette, which could leave dual users unsatisfied and likely to titrate their nicotine intake to reach satiety.

“They are merely introducing more toxicants and nicotine from the added use of e-cigarettes,” added Limpin.

This is after a Filipino dental expert urged smokers to switch to smoke-free alternatives such as e-cigarettes and HTPs. Dr. Fernando M. Fernandez of the Philippine College of Oral and Maxillofacial Surgeons (PCOMS) claimed that switching to non-combustible alternatives will lower the risk of oral diseases and oral cancer as there is no tar and carbon monoxide when there is no combustion.

However, Fernandez failed to mention that e-cigarettes are associated with the carrier product known as propylene glycol (PG) which can be found in e-juices or e-liquids. When used orally, the breakdown of PG includes acetic acid, lactic acid and propionaldehyde, which are all toxic to enamel and soft tissue of the teeth.

E-cigarettes also contains nicotine which is known to cause gum disease and other oral problems such as dry mouth and plaque buildup. Although the percentage of nicotine is much lower than traditional tobacco products, one bottle of 10 ml of 5% nicotine concentration is equal to the nicotine dose of one pack of cigarettes.

Despite being marketed as a safer alternative that have fewer toxins compared to traditional cigarettes, it is becoming increasingly apparent that e-cigarettes possess their own unique health harms and that comparison to cigarette should not be the only relevant question in determining its impact to health. Given that the product is relatively new in the marketplace, further research is needed to evaluate the short and long-term impacts of e-cigarettes.

Evidence regarding the effectiveness of e-cigarettes as cessation tools also remains inconclusive and until the Food and Drug Administration (FDA) publishes a review on these products, the safest cessation strategy is to advise smokers to visit cessation clinics where they can avail a combination of counseling and nicotine replacement therapy.