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As the first vape-related death was recored in the country, doctors and health advocates are calling on parents and the government to save the youth from the dangers of electronic cigarettes.
They also noted that more and more young people have been found using vaping products.
As the country takes part in the observance of the World No Tobacco Day today, the Department of Health (DOH) and medical community warn that vape not only causes lung injury to a healthy young person but also heart attack.
In a case documented by Dr. Margarita Isabel Fernandez and other doctors of the Philippine General Hospital (PGH) in Manila published in the Respirology Case Reports journal of the Asian Pacific Society of Respirology in April, a 22-year-old Filipino male with no prior health issues suffered a fatal heart attack, following severe lung injury possibly attributed to his daily vape use. This was the first vape-related death documented in the country.
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According to the researchers, the patient had no history of cigarette smoking and was not an alcohol drinker nor a user of any illegal drugs. He had also not been infected with COVID-19.
But the 22-year-old admitted he had been a daily user of vape for two years.
The patient was admitted to the emergency room of a hospital some time in 2023 with severe chest pain, difficulty breathing, and experienced a heart attack caused by blockages in his two major arteries.
The patient also developed a serious lung condition known as e-cigarette or vaping-use associated lung injury (Evali).
Further examination by doctors showed severe pneumonia-like symptoms in the lungs, but no infections were detected.
Doctors performed an emergency procedure to open the blocked heart artery, but, despite their efforts, the patient’s condition worsened.
He eventually developed respiratory failure, requiring mechanical ventilation, and passed away three days after hospital admission.
The case was the first in the country that linked vape use to the development of both acute lung injury and heart attack, the researchers noted. This was also the first documented case of vape-related death in the Philippines.
Doctors have documented seven Evali cases in the country since 2019.
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“This should not have happened. In just a short period of time, they were able to find lungs similar to that of a heavy smoker who is already 50 or 60 years old and above. We usually see this case with people with severe heart problems and already have comorbidities,” said internist-pulmonologist Dr. Imelda Mateo in an online forum organized by the Philippine College of Physicians this week.
“We can see here the real danger of vape use in just two years. In a span of three days, we have observed irreversible damage to the patient’s heart and lungs,” she said during the forum.
Grim reminder
For the DOH, the case was a grim warning that e-cigarettes and vape products are not a safer alternative to smoking cigarettes, and could even lead to more dangerous effects on the body.
“May this tragic case serve as a stark reminder of their serious health risks. We urge everyone, especially the youth, not to believe the false advertisements that vaping is a safer smoking alternative, and to make informed decisions to protect their health,” Health Secretary Teodoro Herbosa said in a statement on Wednesday.
“The DOH remains committed to educating the public about the dangers of vaping, and advocating for stricter regulations on these harmful products,” he added.
Health groups are seeing a global trend of decrease in the number of tobacco users. However, Filipinos, especially the youth, are turning to vape products due to their accessibility.
Global survey
According to the latest Global Youth Tobacco Survey in 2019, 14 percent or one in every seven Filipinos age 13 to 15 years old is already using e-cigarettes, translating to almost a million young users in the country.
Medical experts are warning the number of young Filipino vape users could have grown in the past years due to the marketing tactics of tobacco companies, which shifted to developing vaping products that specifically target the youth.
“We are now on the fourth generation of vapes, which are being regarded by the young ones as ‘cool’ because they are like colorful flashdrive sticks hanging on their necks. In addition, these vape liquids are now available in thousands of flavors, including innocent-sounding bubble gum and other fruit flavors,” Mateo said.
Influencers, vloggers
Tobacco manufacturers also tapped social media influencers and vloggers, who are being watched religiously by their young followers. Online sales of vapes are also not properly regulated, with minors having access to electronic payment systems.
“But what the kids do not know is that whatever they are avoiding in conventional cigarette sticks are also in vapes. The chemicals in vapes cause damage to the airways and lungs at an accelerated pace. Consuming one vape juice pod is equivalent to smoking three packs or 60 sticks of cigarette,” Mateo warned.
A law to blame
“And when you are young and you have started using vape, even if you are a nonsmoker, the probability that you will turn to smoking conventional cigarettes is 100 percent because of the nicotine, which is present in both cigarettes and vape products,” she said.
Health advocates are primarily blaming Republic Act No. 11900, or the Vaporized Nicotine and Non-Nicotine Products Regulation Act, which lapsed into law in July 2022, for the surge in vape use in the country, especially among the youth.
The law made e-cigarettes and heated-tobacco products (HTPs) more accessible to the youth by lowering the age of access from 21 to 18 years old. It also transferred the regulation of vaping products from the Food and Drugs Administration under the DOH, to the Department of Trade of Industry, making vaping “a business and profit issue, instead of a public health concern.”
In March, the Philippine National Police reported that during the operations they conducted from May to December last year, 23 percent, or 1,902 of the 8,299 who were apprehended for using vapes in public places were minors.
Poor enforcement
While it had safeguards to prevent the youth from having access to vapes, the law was not enforced properly, Mateo noted.
“But can we protect our children? Yes, we can, by increasing the level of awareness of the dangers of vaping by educating the public, especially the youth and the adults around them. The parents, the teachers, all of us adults are responsible for protecting the young ones,” Mateo said.
Herbosa said he had asked the Department of Education to assist in an intensified information drive among the youth on the health risks of using e-cigarettes or vaping products.