Hello and welcome, my name is Joanna Junak and this is GFN News on GFN.TV. In today’s news:
Philippine’s Vaporized Nicotine Products Regulation Bill has lapsed into law. Peter Dator, President of Vapers Philippines will tell us more.
Colin Mendelsohn is with us to discuss youth vaping and the black market for vaping products in Australia
Samrat Chowdhery, leading consumer advocate from India, will share his thoughts on smoking and vaping in India today
And after the news, Brent Stafford of RegWatch interviews Riccardo Polosa, the Founder of the Center of Excellence for the acceleration of Harm Reduction at the University of Catania in Italy.
Before we go over to today's news, we would like to remind you that from now on, each episode of GFN News is also available as a podcast. Find us by searching for GFN News on SoundCloud, Spotify and Apple podcast.
In the Philippines, we reported earlier in the year that the new Vape Bill was unable to become law without the signature of former President Rodrigo Duterte. Duterte failed to do so before being ousted from office by new President Ferdinand Marcos Jr. The new President had 30 days from receiving the bill to sign or veto it; as he did neither, the Bill “lapsed” into law on 25 July. We asked Peter Dator, President of Vapers Philippines, to explain to us the current situation in the Philippines regarding the Vape Bill.
Peter: Good day, guys. See, Joanna, here in the Philippines, bills cross over from the previous administration to the new administration. That's not something that's pretty common here in the Philippines. You see, we have here a concept, what we call the enrolled bill. So in the final version of the bill is submitted to the President. It has the name of the President, the name of the heads of Congress and arsenal. Here. What happened was the VIP bill was sent to President Duterte on the 24 June, and under our Philippine constitution, the sitting president could either sign it, don't do anything about it, or outright veto it. That's what our constitution in the Philippines says. However, we had an election on the 30 June, the term of president, the 30th ended, and now we have President Bon Bon Marcos, who is actually the one who left to be the decision maker on what will happen with regards to the pending bills from the previous administration. We need to understand that the office of the President is a continuing office. It's just so happened that there are names, there are certain timelines that we need to follow as mandated by our constitution. Like I said earlier, Joanna, it's very common here that there are a lot of bills from the previous administration that was not acted upon and eventually crossed over to the new one. As in the case of the bill, what happened was when it was submitted to President Dorothy, the name of the bill, asigatori was president of the Thursday, do not get me wrong, as far as I know, President Bonbon Marcos can still sign it during his term, but it just would be an absurd situation whereby the name is of a different person. But it will be the same in prices that we will sign for it in the same manner. Occurrences where the loss are being allowed to lapse the bills are being allowed to lapse the law. It's very common here in the Philippines. And just to give a wider perspective to your viewers that upon sitting as president, president Marcos has little two bills prior to the Vape bill or the Vape law lapsing into law on the 25 July. So I would suppose that his team, the people running a government right now, knows of these laws or of these pending bills from the previous administration. I might not be correct, but at least three to five pending bills were vetoed by the process today. I think that the position papers submitted by different organizations, different secretaries that supported the bill might have encouraged the President to allow the Vape law collapse into a law. If there's any takeaway, I suppose that our current president is an ally of tobacco harm reduction, or at least he believes in it.
Joanna: We also asked Peter about the next steps - and what regulations are in force now.
Peter: the next step in our legal process, Joanna, it has to be published. We have an official publication in one of our government agencies. But I understand that the full text of the law was published in a newspaper of general circulation last July 28. So usually after 15 days, it takes effect, and then the primary agency will have to come up with internal rules and regulations on how to go about implementing the new law, because the law, the victim, is technically not yet in effect. We're still following the old executive order issued by the President, Rodrigo Duterte, which was very strict. You can only sell approved flavours. So that's still the one that is in effect. Joanna until the big bill takes effect. So that's probably 15 days from not counting the Saturday, 15 days from July 28.
Joanna: Now to Australia. From the first October 2021, consumers must present a valid prescription from a medical practitioner for all purchases of nicotine vaping products, such as nicotine e-cigarettes, nicotine pods and e liquid. We asked Dr Colin Mendelsohn, tobacco treatment clinician and founding chairman of the Australian Tobacco Harm Reduction Association about the influence this regulation has had on vaping among young people and the black market in vape products.
Dr Colin: Yes. Look, the government introduced new regulations back in October which require vapers to get a prescription from a doctor for possessing nicotine and to use nicotine liquid. And it's actually a criminal offense not to have one. But of course, it's not working. It's too difficult to get a prescription. Doctors won't prescribe Vaping because the government is supposed to it, and vapers don't see why they should have to get a prescription for what's a much safer product. You can go to any corner store and buy a cigarette. So why should you have to get a script for vaping, which is much less harmful and is life saving for so many people? So most actually don't have a script. And some papers have gone back to smoking, which is a tragedy. And not surprisingly, the black market has exploded. So it's just so much easier to go to a tobacco store, a convenience store, and so many of them stock these illegal products under the counter. Millions of illicit disposable vapes are being imported from China every month into Australia. These products are not regulated. We don't know what's in them. There's no quality assurance. They're being sold freely to young people. And because of that, the anti-vaping advocates are calling for a ban. They're saying, well, goodness, all the young people using this price, we have to stop vaping. And of course, that's not the solution. And what's also worrying is that the legal, regulated vape industry is being decimated by the illegal sale of these disposable products. So legal businesses that sell vaping devices and nicotine free products really feeling huge financial stress. And they are closing. Some of them are closing because their customers are going to buy these black market products because they're just so easy to buy. And the black market is making huge fortune. And you can be sure that the criminal gangs will be moving in very quickly. But the solution is very simple. It's not rocket science. We need sensible regulation to make these lifesaving products available to adult smokers who can't quit because it will improve their health. We need to provide quality products and we need to regulate them so they are good quality products. And look, young people shouldn't be vaping. And we need appropriate restrictions to prevent access by young people to products that are illegal and that aren't good for them. And we need to find that balance and just eliminate this prescription model and create a system that will work for both groups. And unfortunately, our government doesn't see the sense in that at the moment. And we've got a very dysfunctional regulatory system at the moment because of it.
Joanna: As part of GFN News’ series of country spotlights, we are going to India. Tobacco is one of the major causes of death and disease in the country, accounting for nearly 1.3 million deaths every year. India is also the second largest consumer and producer of tobacco. Safer nicotine products which potentially could be helpful in quitting smoking were available till September 2019. After that date the government announced a complete ban on e-cigarettes saying that this regulation prevents potential health risks to India's youth. I asked Samrat Chowdhery consumer advocate, a few questions about the situation in India today.
Joanna: Thank you, Samrat, for joining us. Can you tell us what you do and what is your area of interest?
Samrat: I'm Samrat Chowdhery. I'm a consumer advocate from India. I've been a journalist for most of my career, for almost 20 years, and I have been a lifelong smoker. So was my father. But after he passed away, I was quite serious about quitting. And I tried a lot of ways. I tried dumb patches, I went to the doctor to strike me a lot of medicines which give me headaches and didn't work. There were no long term solutions. I would say, Quit for a while and then I'll be back. Then I tried vaping. A colleague at work, and surprisingly, from the sports desk in her office, she was weeping. And I saw the trial once, and it was amazing, because every time that I was trying to quit earlier, there was a nagging feeling in the back of my head that you want to smoke, you want to smoke. And that feeling would been over after some time. But with Vaping a week later, I was surprised that I had not touched smoking even once. I had not missed it because weeping was addressing both the behavioural aspect and, of course, the negotiating aspect. So that was like the European moment for me, for the first time realized that it is possible to get off smoking. There was a dual phase used for a while, and then finally, I think about a year and a half later, I completely switched. Also, the devices then were not that good, and they keep failing. And as the devices got better, it became easier to transition. And so I did. And once I did, that was the time when the government of India was also seriously considering what to do about vaping. And then some states started banning vaping. And that's when we thought, okay, let's organize. Let's do something about it. Let's stem the tide of banks. And that's when we found our official consumer group. We got it registered, it's one of the oldest nation and then started fighting against these banks. Initially, we thought that it would be quite simple. It's fairly evident that India has a huge tobacco problem. 39 and a half, 1.3 million people die from tobacco use every year. And this is a ready solution. We also don't have that many resources to provide suspicion, support and counselling and support 267,000,000 people who use tobacco. And here was a solution that could help a lot of people, and so the government would look at it favourably. But what we didn't factor in was two things. Maybe one, the anti-tobacco groups were against anything, any information in tobacco, and of course, the government's own interest in the tobacco trade because the government directly participates or owns a major part of the largest tobacco company. So we had a banana. Here we are fighting against it.
Joanna: Is the government of India supporting people to have better access to safer nicotine products?
Samrat: Sure. I don't have very good news from India because I think the main problem is the tobacco is seen essentially from the financial angle and not from the health perspective, even though it's a major health issue. Tobacco is the largest killer of Indians by any measure, and yet the whole situation is viewed mostly from the financial perspective, how much revenue the government earns, how much land is under tobacco cultivation. Strangely, this year the amount of land under tobacco cultivation went up in India, which is against anything, any anti-tobacco measure. And that's because they are viewing it from farmers perspective, from employment perspective, and not necessarily from the health perspective. So the policies are in that sense very skewed and I don't think they are helping anyone because first of all, the entire focus is on cigarettes. And cigarettes is a very small competent of tobacco use in the country. The largest product which is used the most is a smokeless tobacco product, which is again very deadly, leads to about 350,000 a year. And the next is Busy, which is a hand roll tobacco, which leads to almost a million deaths a year. So there's no action on those. Those are hardly taxed available, very cheap, and it seems the entire focus is on cigarettes, which doesn't help much. So the policies, they're looking good on paper and they continue waddling. But when you live in India, and when you see what's happening around you, then you realize it's not really effective and it's not being viewed correctly. The other problem is that while people in the health ministry and the government keeps saying that nicotine is really addictive, it's 3000 times more addictive than heroin. That's what the health minister said in parliament two years ago. There is no real action on providing smokers and tobacco users support, so there is no in person counselling. NRT, instead of being subsidized, are being taxed at the highest lap, so there's no meaningful support. So I wish there was a real look on how to backup policies in the countries are being viewed. So instead of helping smokers, to give you an example, the taxes on cigarettes were not raised the last two years, but they raised taxes on NRC. So I don't think there's a good thinking on this. And I wish there was a little more pro people and how to help people and what people are going through and their struggles and involving tobacco users and policymaking, none of that is happening currently. And I wish that thing.
Joanna: When the government - or other organizations in India - give people reliable information regarding using safer nicotine products, and show them how these products can be used to quit smoking, do you think the smoking rate will drop?
Samrat: Certainly. Information is one thing. I think a lot of people are aware of the background. What they are confused about and often don't know is how to quit. So then you have a proliferation of all these cracked remedies, the local remedies, someone comes up and says, okay, you do meditation and you can quit. I think our health Minister once said, you can have chocolate. So people know that tobacco use is harmful, but what they are not being told is the correct way to quit. And I think a lot of it comes from a misconception that tobacco use or people are using tobacco out of choice. They're waking up every morning and making a decision to smoke, which is not true entirely because they are dependent, they require support, and that's where the chain breaks. So a lot of these efforts are, okay, you can create on your own and all you need is willpower. But we know that willpower back to can succeed only 5% of the time. So we need more effective solutions and correct dissemination of information from the government. Now in 2019, they banned Vivian. Now that's going to send out a message and at the same time, they did not raise taxes on cigarettes for two years. So what kind of message is that sending people? So I think there is a serious miscommunication and also through policy measures and taxation measures. But if people have the right information, I'm sure no one wants to die from smoking. So they would make the right choices if they were given options at affordable prices and the availability was good.
Joanna: Thank you, Samrat, for sharing your thoughts. And now, we go over to Brent Stafford and his guest, Professor Riccardo Polosa, the Founder of the “Centre of Excellence for the acceleration of Harm Reduction” at the University of Catania in Italy. Riccardo is actively involved in smoking prevention and cessation. He established the first Sicilian centre for smoking cessation at the University of Catania in 2002. In today’s interview, Riccardo challenges misinformation around the health impacts of vaping and shares research that shows nicotine vaping products are less harmful. Over to you, Brent.
BRENT: Hi Brent Stafford and welcome to another edition of RegWatch on GFN.TV. We're here in Warsaw, Poland for the Global Forum on Nicotine. And joining us is Dr Riccardo Polosa from the University of Catania. How's it going?
Riccardo: It's going well. Thank you very much.
Brent: You know, the last time that you and I spoke, it was really all about heat, Ali. And you just finished doing some interviews with CNN in Europe. What did you think of the questions they were asking you?
Riccardo: I think that it's a very stupid to keep talking about a value today. I think what we really need to do today is to stop a minute and rewind. What do I mean? I mean that we should show the world that all the case was a big bluff. And now that there's not a single Ebola case in the world, that makes a case for the legal nicotine products. So if you really want to talk about the scare about nicotine, legal nicotine products all around the world, just show that there is no Evali anymore.
Brent: So where does the research stand right now coming out of your centre about the harm or lack of harm with regarding nicotine vapes?
Riccardo: Our centre is focusing on different directions. One first direction is to make sure that these products do indeed have less harm. So I guess one of the most interesting studies we've completed recently and was published in Nature last year in December was sort of a ring trial of cytotoxicity of the products. Basically what we did was to take some of the most quoted papers from the industry showing that there was no cytotoxicity associated with the use of these products. And we replicated in a way that five different labs all around the world using the same harmonization procedure, same standards, same equipment, the same products, were going to provide the same results. And so that happened. So we basically five different labs demonstrated very low cytotoxicity level of electronic cigarettes compared to the huge cytotoxicity levels of tobacco combustibles.
Brent: And, you know, help our viewers understand this and myself a little bit better. Is the cytotoxicity linked to immune system issues?
Riccardo: Not really. Cytotoxicity can be partly linked to immune system. But the way I see it, it's cytotoxicity is the first stage of a damage that can lead to several diseases, particularly cardiovascular and respiratory. In some areas, it can be also be accepted to the area of oncology, although in that area you do different types of experiments called mutagenesis, genotoxicity and so forth. So but it's in my opinion, is the first indicator that the product is non or toxic.
Brent: A big interview we did with you back in December of 2017 was for a story titled Case Closed, and a lot of people really responded well to that. Is the case closed in terms of the harms with vaping today?
Riccardo: Even more so if you think historically when you did the analytical evaluation of these products in, let's say, 2009, I still remember FDA evaluating these products and identifying some very nasty chemicals in the products. So I see over the last decades or so, there's been an overall improvement in the quality and safety of these products, including the liquids. So this is an innovation or product is going to go improve itself over the years. Of course, some level of checks in terms of standard standardization, safety, quality control, quality assessment is needed, but I can see a very pinkish future for these products and cases closed.
Brent: One of the one of the charges against that piece of research and others is that it's not a long term study. It's not long to tune it. All right. Is that still an issue? Because it's something we still hear today that there's no long term studies.
Riccardo: I think you're referring to the study in which we assessed the high resolution seat is kind of the lung which was carried out for an average period of four years. Four years is a decent time, but it really depends on the research question that you're asking. The research question we were asking that time was, if I investigate a vapor who never smoked in his life, what I'm going to see down in his lungs. And we decided to use high resolution CT scan because it is still is the most sensitive way to assess damage in the lung at that time, although a very small population, very small sample size, we could not spot one single subject in any of the subjects, any lesions measured by high resolution CT scan. Of course, it would be ideal to have a very large study with hundreds of vapers who never smoked in their life to be followed for at least 5 to 10 years to have a final answer to that question.
Brent: And that's difficult to kind of generate that research, isn't it?
Riccardo: It is. It is. But we do know now that these products have been around for more than ten years, and to the best of my knowledge, none of the legally marketed nicotine ice vaping products have ever caused any form of disease.
Brent: So let me ask you about Canada, for instance. You know that they legalized vaping and that became law in 2018. And all of a sudden, you know, we had a legal vape market. But the moral panic over the so called teen vaping epidemic and then hit with a valley the year later has left the Canadian vaping industry and consumers of vaping products pretty much out in the cold. They'll Health Canada cut nicotine concentrations by over half. They're threatening a full flavour ban and they're mimicking pretty much the same concerns that come out of the anti-vaping advocacy effort in the US. What can as a scientist who spends a lot of time studying in this area, what can we offer Health Canada in terms of some insight on the science that could make a difference?
Riccardo: I mean, I'm very open to any regulators or politicians, policy makers or colleagues that really want to approach me and trying to have a civil discussion about science, about quality science. What I think most of these reactions that Canadians are having are based on emotion, not science. All the Evali case we already just discussed about that just a minute ago is simply due to contamination of a product into sort of an illegal product. So nothing to do with the legal nicotine vaping products. So why mixing the two bags? Why taking oranges and making them apples? Why are you so scared about that? Let's be honest. I think that there is an agenda and the agenda is let's get rid of vaping products and they try to cover these prohibitionist agenda by. Leveraging Evali or the teen vaping epidemics that we know it doesn't exist anymore. It's never been a real epidemic, to be honest. By definition, an epidemic needs to reach some levels. And if you look at those other federal surveys of those very famous and white. Yes. And ages, the various surveys that have been run to substantiate the scare, there is actually no scare because most of the guys, most of these kids, most of these young adults were already smoking the vast majority. And people tends to forget that. So basically, vaping has been acting as a gateway out of smoking, no gateway into smoking. And in any case, I think it's very honest to say that we really need to keep vigilant to maintain the monitoring through this service and see what's going to happen in the next two or three years. Because to be honest, Evali may have introduced some big bias in the recording of this survey. So maybe I would say the jury is still out, but for that exact reason, you don't have to rush to make policies out of the way. Right? Right now, we can just wait a couple of years. Nothing is going to happen and maybe we're going to get away with a better decision for the best good of all the Canadians and Americans.
Brent: What do you make of the statement that nicotine harms developing brains?
Riccardo: Uh. I think a mixed me mixed feelings. Most of the evidence is based on animal data, so it is very difficult for me to try and translate animal data into human beings. As you can imagine, I always very much opposing this way of dealing with science. You have a demonstration in rodents. It needs to actually work in humans. Never. It never does. Not even when you study drugs that works in rodents eventually will work in humans, at least in respiratory field. There are hundreds and hundreds article articles that they are dismissing this view. Of course, miners should not take any negative. That's a fact. Minors should not drink any alcohol. Minors should not drink any coffee. That's the point. So let's be more focused on implementing the existing law. Now there is a t 21. That's fine. It's a good to have a T 21. Good to have raised the limit of usage to psychoactive drugs to a level of 20 years old. But if you don't implement those laws, you're not doing anything. And then we are back to base. We are thinking about banning flowering and banning products. To what end? We are going to damage adults that they are making a greater use of these products and they are really being successful in quitting for good.
Brent: Dr Polosa, what's your thoughts with regard to this phenomenon we're seeing where academics who are open to tobacco harm reduction and tobacco harm reduction research are being ostracized and sometimes cancelled from participating in some aspects of the scientific community. What do you know about that and what are your thoughts?
Riccardo: I always thought academic freedom had no boundaries. So my thought is, is a kind of a negative one. I think you have to look at the science. Wherever comes this science and this is it. Basically, I don't I don't think there's anything else to say. I think people that apply ostracism to colleagues is always a bad thing. You just need to come and have a civil discussion with the data and discussing just about science.
Brent: And lastly, for those people out there in the regular general public who seem to be distrustful of science, what do you say about that with regard to tobacco harm reduction? I mean, is there a legitimate reason to distrust science? And maybe on both sides there's a distrust.
Riccardo: Well, and distrust it is a way to minimize the position of who is proposing. You know, a theory over another. I really think there is no such thing like the perfect study. So based on that, we all need to be aware that even our science may not be perfect. And it is perfect. But it can be profitable only if you discuss it, particularly with the opponents, because there can be a very good critics of your work. But this works both ways.
BRENT: Yeah. The opponents don't seem so open to sitting at the table.
Riccardo: Exactly. I'm very open. I try to criticize myself before publishing any paper. My discussion are full of limitation, and in fact, my opponents, they just parrot what I've already said in my limitation chapter in the discussion.
Brent: Well, your work, Dr Polosa says, inspirational for many.
Riccardo: Thank you. Thank you very much for having me.
Joanna: That’s all for today. Tune in next time, here on GFN TV or on our new podcast, for more tobacco harm reduction updates and Brent’s interview with Lindsey Stroud, Director of the Taxpayers Protection Alliance’s Consumer Centre in the US. Thanks for watching - or listening! See you next time.