The Department of Health (DOH) and the Food and Drug Administration (FDA) warns the public on the adverse health effects and safety concerns associated with the use of Electronic Nicotine and Non-Nicotine Delivery Systems (ENDS/ENNDS) more commonly known as electronic cigarettes.

In 2015, the Global Adult Tobacco Survey (GATS) recorded that the overall prevalence of ever users and current users of e-cigarettes in the Philippines was 2.8% and 0.8%, respectively. Given the rapidly expanding global market for this new class of devices, the local consumers of e-cigarettes are likely to have also increased.

In the interest of informed policy development, the DOH and FDA would like to provide the following information on the state of current science on electronic cigarettes.

E-cigarettes or vapes are combinations of non-tobacco-containing e-liquids or refills and an electronic delivery device. These systems produce aerosol, mist, or vapor that users inhale by mimicking the act of smoking. Current literature shows that composite contents of and emissions from these devices are not completely without harm.

Five US medical specialty societies (American College of Obstetricians and Gynecologists, American College of Physicians, American Academy of Pediatrics, American Academy of Family Physicians, American College of Surgeons) have unanimously stated that these devices are health hazards. The Philippine Pediatric Society has likewise been vocal about its strongly addictive and potentially cancer-causing effects.

The Department cautions the public regarding harmful chemicals in these devices such as nicotine, ultra-fine particles, carcinogens, heavy metals, and volatile organic compounds. Results generated from peer-reviewed studies show that e-cig juices contain high levels of addictive nicotine, which can result in acute or even fatal poisoning through ingestion and other means. In addition to nicotine addiction, cases of nicotine toxicity in children of epidemic proportion have been documented in other countries with increasing prevalence of e-cigarette use. E-cigarette aerosol that users and bystanders breathe and exhale also contain harmful and potentially harmful substances including second-hand aerosols (SHA).

Since these products have a unique appeal to the youth, due to the prevalence of flavored variants and their unique construction, the DOH and FDA strongly appeal to parents, teachers, and health workers to educate children and adolescents about the health risks of e-cigarettes.

“The Department, together with the Food and Drug Administration, maintains that a series of long-term epidemiological and peer-reviewed studies are required to conclude that e-cigarettes are less harmful than conventional smoking,” said Health Secretary Francisco T. Duque III.

Contrary to the claim regarding the effectiveness of e-cigarette as a smoking cessation aid, there is barely sufficient evidence-based research to prove so.

“While there is a lack of conclusive data regarding the long-term effects of using e-cigarettes, its health risks cannot be set aside. The precautionary principle recommends that, until conclusive data regarding their safety have been established, regulatory measures should aim at reducing exposures to these products,” added Secretary Duque.