Vapes and HTPs may reduce health risks for smokers, says heart expert

According to a renowned Filipino cardiologist, smokeless products such as vapes and heated tobacco products can significantly reduce health risks for Filipino smokers if they opt for these alternatives.

“Although the use of alternative tobacco products does not completely eliminate harm, they can significantly reduce or mitigate health risks. Personally, I believe this is the best bet of all the smoking cessation measures currently available to help recalcitrant smokers really solve the problem of smoking, not only in our country but around the world,” said Dr. Rafael R. Castillo, the first Filipino and Southeast Asian to be elected as a trustee of the UK-based International Society of Hypertension, said at a recent satellite symposium at the Philippine Heart Association’s annual convention .

Dr Castillo, former president of the Philippine Heart Association-Philippine College of Cardiology and the Asia Pacific Society of Hypertension, said that while complete cessation of smoking remains the primary goal, “we have to face the reality that we can’t achieve that”.

“At best, after a year of specialist support and drug treatment, the successful quit rate is only 20%. So, at best, you only achieve a 20% success rate,” said he said during the virtual discussion at the PHA’s 70th anniversary and 52nd annual convention and scientific meeting.

“Our dropout rate is not that encouraging. Worldwide, the dropout rate is really very low. At best, in countries where the intervention is very aggressive, it is only 20% in one year. It’s not good enough. That’s why we think offering them alternative products that can wean them off tobacco would be our best bet at the moment,” he said.

Dr Castillo said that as part of their due diligence in deciding whether or not to allow alternative tobacco products in their smoking patients, their research group at FAME Leaders Academy conducted a systematic review and meta-analysis on the effects of heated tobacco products compared to traditional tobacco cigarettes on heart rate, blood pressure and other predictors of cardiovascular risk in adult smokers. The study showed significant differences in certain risk factors that may favorably impact the cardiovascular health of smokers.

HTPs and other alternative tobacco products can be part of tobacco harm reduction that is rooted in the fact that certain lifestyle practices or bad behaviors are simply unavoidable, he said.

“If so, our next goal is to minimize the harm people suffer as a result. People make bad life choices despite the negative effects on their health. Quitting smoking completely is the main goal, but it is not achievable. There must be a pragmatic middle ground. There will still be around one billion smokers in the world by 2025 if the smoking problem is not addressed aggressively,” he said.

The more than 16 million Filipino smokers, many of whom suffer from addiction, deserve a viable alternative that can wean them off cigarettes and help them quit, he said.

The smoking problem is a serious challenge that is worse than the Covid pandemic. “Smoking is also the main risk factor for cancer in the Philippines. Smoking is a serial killer that kills so many people,” he said.

Dr. Castillo said that for recalcitrant smokers or those who cannot quit despite smoking cessation interventions, “the use of electronic nicotine delivery systems or alternative tobacco products can serve as a testing ground. pragmatic agreement to reduce the damage and eventually bring it to a complete halt”.

“With all the heartbreaking failures we’ve had to get recalcitrant smokers to quit, we have to face reality. We must offer alternatives to recalcitrant smokers and give them more tools. Tobacco addiction is not something they simply cannot overcome. We’ve tried all kinds of quit smoking interventions (patches, nicotine gum, etc.) but we’re getting nowhere. We’re not really progressing as much as we would like,” he said.

The Philippines now has the second highest smoking prevalence in Southeast Asia, after Indonesia. “While cardiovascular disease is the leading cause of death in the Southeast Asian region, causing more than one in four deaths [3.96 million deaths or 29 percent of all deaths]tobacco is the main preventable risk factor causing the highest number of deaths in the region — more than 1 in 10 deaths [1.51 million or 11.6 percent of all deaths],” he said.

Dr Castillo said tackling the smoking problem requires a pragmatic approach, as the decline in smoking rates has been slow under the current strategy which involves the use of nicotine replacement therapy.

“Nicotine can also be part of the solution to the smoking problem, and it can be part of any intervention we want to use to reduce the harms of smoking,” he said, while denying that nicotine is the main cause of smoking-related problems. diseases.

“Tobacco smoke contains 7,000 chemicals, including nicotine. Smokers often have the impression that nicotine is a major carcinogen. The currently available evidence does not suggest that nicotine by itself induces cancer,” he said.

Nicotine, as an addictive substance, should also play a crucial role in reducing tobacco harm. “Nicotine is the heart of the problem, but also the centerpiece of the solution,” he said.

Dr Castillo said a 2019 UK study showed e-cigarettes were more effective than nicotine replacement therapy in getting smokers to quit. “The results concluded that e-cigarettes were more effective in quitting smoking than nicotine replacement therapy, when both products were accompanied by behavioral support,” he said.

Dr. Jorge Sison, who moderated the PHA forum, said that while smoking prevalence in the Philippines fell to 25% last year from 27% in previous years, the ratio remains high.

Dr. Sison, former president of the PHA, said reducing the harm from tobacco is a promising strategy. “I hope our government will open its eyes and welcome new additions to our anti-smoking campaign,” he said.

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