CAPHRA: Philippine anti-vape commentary asks the wrong public health question

METRO MANILA, Philippines - EntSun -- The Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA) says a recent Philippine commentary on vaping and heated tobacco misframes the science by focusing on whether smoke-free nicotine products are harmless instead of whether they are safer than cigarettes for adults who would otherwise continue smoking.

CAPHRA said this distinction is central to sound public health policy. No credible tobacco harm reduction advocate claims that vaping or heated tobacco products are risk-free. The real question is whether non-combustible nicotine products reduce exposure to the toxicants most responsible for smoking-related disease.

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"The question has never been whether these products are harmless," said Nancy Loucas, Executive Coordinator of CAPHRA. "The question is whether they are substantially less harmful than combustible cigarettes and whether they can help reduce smoking-related disease among adults who would otherwise keep smoking."

CAPHRA said the journal article is a commentary, not a clinical trial, cohort study, systematic review, or meta-analysis. In a detailed response (https://caphraorg.net/wp-content/pdf/Lorenzo_Ma...) requested by CAPHRA from Dr. Lorenzo A. Mata Jr., he argues that the commentary repeatedly confuses hazard identification with comparative risk assessment and gives too little weight to switching evidence, biomarker studies, and the role of combustion in smoking-related disease.

The group said the commentary raises legitimate issues around youth use, residual risk, and product quality. But CAPHRA warned that these concerns do not justify treating smoke-free alternatives as equivalent to cigarettes or jumping from concern to support for broad bans without addressing what happens to smokers who lose access to lower-risk options.

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"When policymakers treat 'not harmless' as if it means 'just as bad as smoking,' they risk protecting cigarettes from competition while closing off better alternatives," Loucas said.

CAPHRA said effective policy should protect youth through age restrictions, enforcement, product standards, and responsible marketing while preserving lower-risk alternatives for adults who would otherwise continue using combustible tobacco.

"Public health should be judged by whether it reduces smoking-related disease in the real world," Loucas said, "not by whether it demands perfect safety from every alternative to cigarettes."