• May 22, 2024

Persistence Pays

 Persistence Pays
Photo: alisaaa

Lessons from consumer advocacy groups that successfully fought for vaping regulation

By Stefanie Rossel

In the shaping of tobacco control legislation, the consumer is often ignored. Many governments find it easier to deny the health benefits of switching from combustible tobacco products to reduced-risk alternatives and simply ban less harmful nicotine-delivery systems. According to The Global State of Tobacco Harm Reduction, 37 countries currently prohibit the sale of nicotine vaping devices, and many others treat vapes like conventional tobacco products, which means restrictions on public consumption and bans on the promotion of e-cigarettes as safer alternatives to smoking.

The consumer is typically denied a voice, as is the case at the Conference of the Parties to the World Health Organization Framework Convention on Tobacco Control (FCTC) (COP10), which will be hosted in Panama this November. Consumer advocates will not be allowed to participate in the event, not even as observers. The FCTC Secretariat, meanwhile, discourages treaty signatories from speaking with any group that is even remotely associated with the tobacco business, making interactions next to impossible.

Despite such restrictions, recent examples show that with persistence, consumer advocacy groups can make a difference. For example, last year, the Philippines, a country with 19.9 million smokers, replaced its 2019 vaping ban with a sensible regulatory framework. Republic Act (RA) 11900, also known as “the vape law,” legitimizes vaping as a strategy for smokers to reduce their health risk, and it lowers the age at which vape products can be legally purchased from 21 to 18. Furthermore, the law moves the authority to regulate vapes and heated-tobacco products from the Philippines Food and Drug Administration (PFDA) to the Department of Trade and Industry. In 2021, the PFDA came under pressure after it was revealed that it had accepted significant funding from Bloomberg Philanthropies, a move that critics said subjected the Philippines’ health policy to foreign influence.

The adoption of the vape law in the Philippines can largely be attributed to the persistent efforts of consumer organizations in countering misinformation.

Peter Dator, president, Vapers PH

Engagement is Key

Tobacco harm reduction (THR) advocates consider the Philippines’ vape law “a minor miracle” as it prevailed in a region that is strongly influenced by Bloomberg Philanthropies and the WHO, both of which tend to favor prohibitionists tobacco control approaches. Many Southeast Asian countries, including Singapore and Thailand, have banned vape products in line with WHO recommendations.

“The adoption of the vape law in the Philippines, despite the influence of anti-THR groups, can largely be attributed to the persistent efforts of consumer organizations in countering misinformation,” says Peter Dator, president of consumer advocacy group Vapers PH. “These groups have been instrumental in challenging misconceptions surrounding vaping, advocating for evidence-based harm reduction strategies and ensuring that accurate information reaches policymakers and the public.

“Through their consistent and dedicated campaigns, consumer organizations have played a vital role in shaping a more informed and balanced perspective on vaping, thereby influencing the decision to overturn the ban and embrace a more pragmatic approach to tobacco harm reduction in a region where such legislation has often been swayed by ideologically driven influences.

“Vapers PH actively engaged in the process of overturning the vaping ban in the Philippines by taking concrete steps, such as leveraging social media platforms to raise awareness and disseminate accurate information about vaping’s benefits and risks. Additionally, we participated in various forums and public consultations dedicated to the vape bill, providing expert insights and representing the interests of vapers. By actively contributing to public discussions and presenting evidence-based arguments, our group, alongside several other vaping consumer groups here in the Philippines, played a crucial role in influencing the reconsideration of the ban and encouraging a more nuanced approach to vaping regulation.”

Manufacturers, distributors and retailers are currently working through an 18-month transitory period to comply with the new legislation. Recently, the Philippines released guidelines for flavors, which, according to Dator, focus mainly on preventing their marketing to minors. For example, e-cigarette companies may not give their flavors names that may appeal to children.

The Importance of Enforcement

As a representative of consumer advocacy, Dator says he is pleased to see that the bill has taken steps toward regulating the vaping industry in a fairer manner than before. “However, while I appreciate the progress made so far, I believe that there is still more work to be done in terms of implementing these regulations effectively,” he says. “It’s important that the regulatory framework is comprehensive and well enforced, ensuring that manufacturers adhere to quality standards, provide accurate product information and refrain from targeting minors. Additionally, there should be measures in place to monitor and assess the long-term health effects of vaping products as this information is crucial for consumers to make informed decisions about their health.”

Dator believes the rules should be strengthened to ensure the safety and well-being of consumers. “The ultimate goal should be to strike a balance between providing adults with a potentially safer alternative to traditional smoking while also preventing any unintended negative consequences, particularly among younger individuals,” he says.

“While the bill has transformed into law, its true impact depends on how well the regulations are enforced and monitored. If the implementation process lacks rigor or faces challenges in terms of oversight and enforcement, there is a notable risk that the objectives of the law could be undermined. Therefore, the success of the law hinges on the commitment to robust implementation strategies that ensure compliance with the intended regulations and prevent any potential subversion of the law’s intent.”

Sharing information, knowledge and strategies are key, especially in a regional context as what happens in one country may/will impact surrounding countries.

Nancy Loucas, co-founder, AVCA

A Resource of Information

New Zealand, too, has been praised for its regulation of vaping. Unlike Australia, where vape products are available only on prescription, vaping remains legal as a smoking cessation tool under New Zealand’s Smoke-Free Aotearoa 2025 Action Plan, an amendment of the Smokefree Environments and Regulated Products Act (SFEA) from 1990.

As in the Philippines, consumer advocates helped shape regulation in New Zealand. As the process to regulate vaping under the SFEA got underway, advocates contacted elected officials, health providers and community groups and offered to be a source of information. Members of the Aotearoa Vapers Community Advocacy (AVCA), for example, attended meetings to present science and research.

“AVCA had an approved vendor list whereby the vendors agreed to equipment and liquid standards to self-regulate the industry,” says AVCA co-founder Nancy Loucas. “We gave this to the government to use as a template.”

Loucas believes that New Zealand’s comparatively small size and progressive policies made it easier to help shape sensible, evidence-based regulation that recognizes the principle of harm reduction. “Because of the economies of scale, it is much easier to engage with officials here than in Australia, “ she says. “Australia is very conservative—authoritarian—comparatively.”

Loucas is also executive coordinator of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates, an unfunded grassroots alliance among the THR advocates and their respective organizations in the region.

She says collaboration among consumer advocacy groups from different countries is beneficial for consumers and consumer groups. “Sharing information, knowledge, strategies are key, especially in a regional context as what happens in one country may/will impact surrounding countries,” she says. “Commiseration and support is also important on a mental health level. Advocacy is not easy, and a burden shared is lighter.”

The challenges we have been facing for almost a decade is the ignorance of a few control freaks.

Asa Saligupta, head, ENDS Cigarette Smoke Thailand

Educating People

As the head of ENDS Cigarette Smoke Thailand (ECST), Asa Saligupta knows that consumer advocacy can seem like a Sisyphean task. Thailand has one of the world’s strictest vape laws, enacted in 2014. In the runup to the elections, THR activists had high hopes the new administration would lift the country’s ban on vaping. However, despite gaining the most seats in the House of Representatives, the progressive Move Forward Party was blocked from forming a government by allies of the monarchy and military in the Senate.

Yet Saligupta remains optimistic. “My humble opinion is that no matter who will win the election and who will be our next Prime Minister, the vaping ban will be lifted. One of the delegates already proposed to set up a committee to look into it, and he was supported by enough votes that this bill is already waiting in line at the parliament.”

While anti-vaping groups like to boast about Thailand’s harsh regulations, the country has a problem with enforcement. Bribery is a big issue. “The challenges we have been facing for almost a decade now is the ignorance of a few control freaks, plus you have to admit we are living in a social media era,” says Saligupta. “We don’t have enough resources to fight them. They kept coming with blatant lies after lies, along with misinformation. Fortunately, the ban does not include possession or the act of vaping unless you vape in a no smoking area. So, for us to go out to the public and tell them that vaping is safer than smoking is not against any laws, yet.” ECST is in touch with its counterparts in the Philippines and hopes to duplicate their accomplishments. “We have talked about copying their laws,” says Saligupta.

Even as it maintained its ban on vaping, Thailand’s Food and Drug Administration July 2022 took cannabis off its narcotics list, legalizing possession, cultivation, distribution and consumption under certain conditions. Since then, thousands of cannabis shops have opened. However, there’s little support for similarly relaxing vaping restrictions, according to Saligupta. “But of course, we can point out the harm and addiction,” he says.

ECST has done a lot to get the ban lifted. “We attended many seminars at the parliament; we sent a petition to the Ombudsman,” says Saligupta. “Now the hearing is over, and we are expecting results soon. I also host live casts at the weekend, with more than 100,000 followers, etc. I traveled worldwide to educate people on the situation of vaping in Thailand. Our next step is to wait and see who the government will be. For what it’s worth, I think almost all parties agree that vaping should not be banned but controlled.”

Beating a Flavor Ban

Meanwhile, in Europe, the EU is in the process of implementing its 2021 Beating Cancer Plan and preparing to review its Tobacco Products Directive (TPD). In 2022, THR proponents rejoiced when the European Parliament for the first time recognized the THR concept with the adoption of a report by its Special Committee on Beating Cancer (BECA).

That success can at least in part be attributed to the work of consumer representatives. “Along with our 24 partner associations, I think we played a significant role,” says Damian Sweeney, a partner in the European Tobacco Harm Reduction Advocates (ETHRA).

“From the beginning of BECA’s mandate in September 2020, we wrote and published articles on the BECA meetings to inform consumers about what was going on. As the meetings progressed and amendments were tabled and discussed, we could see that flavors were under threat. So, along with partners, we wrote to all members of the BECA Committee on three occasions to outline the importance of flavors in the success of vaping products as a harm reduction tool.

“Another important recommendation to come from BECA—and something we also raised with committee members—was that risk assessments should compare the use of safer nicotine products [SNPs] to smoking. Although we don’t think the final report was specific enough as it said risk assessments should compare safer nicotine products to ‘consuming other tobacco products,’ this was still a positive, as it calls into question the validity of the Scientific Committee on Health, Environmental and Emerging Risks Opinion, which compared risks [of safer nicotine products] to nonsmoking.” 

Cooperation among consumer advocacy groups is vital, according to Sweeney. “One of the founding principles of ETHRA was to coordinate and amplify the tobacco harm reduction voice in Europe, in support of millions of nicotine consumers,” he says. “One of our biggest strengths is our partner associations and how we work together to further the goals of THR.”

The ETHRA has recently been busy with the revised TPD, which is expected to be adopted in 2024. “We have been actively involved at every stage of the evaluation,” says Sweeney. “We’ve taken part in numerous calls for evidence, public consultations, and been invited to participate in targeted stakeholder consultations and interviews. As the next iteration of the TPD will impact millions of consumers of safer nicotine products, it is essential that consumers have a voice, and it has been our mission to ensure consumers have that voice.

“Our message has been simple—safer nicotine products are a popular and effective means to quit smoking and are proven to be substantially less dangerous. Policymakers should consider the opportunities safer nicotine products offer in reaching smoke-free targets and be acutely aware of potential unintended consequences of prohibitive policies, such as flavor bans or high taxation.”

Recently, the ETHRA wrote to members of the newly formed EU Subcommittee on Public Health (SANT) ahead of the presentation of the Rapporteur’s Draft Report on noncommunicable diseases (NCD). “We highlighted that ‘tobacco use’ was erroneously identified as a risk factor when it should be ‘smoking.’ We also outlined the importance of safer nicotine products in reducing smoking and NCD prevalence. During the meeting, two members of SANT, who were also in BECA, asked that the BECA recommendations on SNPs be incorporated into the final SANT report. So, I’m quietly confident that those positives will be included.” 

By continually challenging misconceptions, promoting accurate information and participating in public discussions, consumer organizations can help shape a more informed perspective on vaping and other harm reduction strategies, ultimately influencing policy decisions in favor of public health and individual choice.

Damian Sweeney, partner, ETHRA

Valuable Lessons

So what can consumer organizations in other countries learn from their colleagues in the EU, the Philippines and New Zealand?

“For me, political engagement is one of the most important parts of advocacy,” says Sweeney. “I would encourage other consumer groups to get in contact with their representatives at local, national and EU level to make them aware of the importance of tobacco harm reduction. It’s also important to participate in consultations when restrictive policies on safer nicotine products have been proposed. And, if you are part of a consumer group that is independent of industry, I’d highly advise joining ETHRA as a partner.”

“Consumer organizations from other countries, like India [which prohibits vaping], can draw valuable lessons from the Philippines’ experience in vaping advocacy,” says Dator. “One takeaway is the importance of unwavering persistence in fighting against misinformation and advocating for harm reduction alternatives. The Philippine example shows that even small efforts, when consistently carried out by a collective of dedicated vaping advocates, can create a significant impact over time. By continually challenging misconceptions, promoting accurate information and participating in public discussions, consumer organizations can help shape a more informed perspective on vaping and other harm reduction strategies, ultimately influencing policy decisions in favor of public health and individual choice.”

Loucas reminds consumer groups that elected officials work for them. “They should approach them with respect and integrity and present facts—but most importantly, their testimony,” she says. “Humanize the issue.”