Filipino smokers deserve cigarette alternatives - expert

A heart expert said that Filipino smokers deserve alternatives to cigarettes that will significantly reduce health risks, wean them off and eventually make them quit.

Dr. Rafael Castillo, the first Filipino elected as trustee of the United Kingdom-based International Society of hypertension, said the smoking problem in the country is a “serious challenge” that is worse than the Covid-19 pandemic.

“Smoking is the number one risk factor for cancer in the Philippines. Smoking is a serial killer that kills so many people,” he added.

Castillo said that the use of electronic nicotine delivery systems or alternative tobacco products will serve a “pragmatic middle ground” to reduce harm and eventually make smokers quit completely.

“We have to offer recalcitrant smokers alternatives and give them more tools. Smoking addiction is not something that they cannot simply overcome. We have tried all sorts of smoking cessation interventions (nicotine patches, gums, lozenges etc.), but we are not getting anywhere. We are not really progressing as much as we would like to,” he said in a virtual discussion during the 70th anniversary and 52nd annual convention and scientific meeting of Philippine Heart Association.

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He said that the Philippines has the second highest prevalence of smoking in Southeast Asia, next to Indonesia.

“While cardiovascular diseases are the leading cause of death in Southeast Asia, causing more than 1 in four deaths, tobacco is the leading preventable risk factor causing the largest number of deaths in the region – more than 1 in 10 deaths,” he said.

He added that addressing the smoking problem needs a pragmatic approach as the decline in the smoking rate has been slow under the current strategy that uses nicotine replacement therapy.

Castillo said that heated tobacco products and other alternatives can be part of tobacco harm reduction which is anchored on the fact that there are some lifestyle practices or bad behaviors that are simply inevitable.

“People make poor lifestyle choices despite suffering negative health effects. Complete smoking cessation is the primary goal, but it is not achievable. There has to be a pragmatic middle ground. There will still be around one billion smokers globally by 2025 if the smoking problem is not aggressively addressed,” Castillo said.

“Our quit rate is not that encouraging. Worldwide, the quit rate is really very low. At best, in countries with very aggressive intervention, it is only 20 percent in a one year time. It is not good enough,” he said. “That is why we believe that offering them alternative products which can wean them from smoking would be our best bet at the moment.”

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