THE Department of Health (DoH) has directed all hospitals to properly document any illnesses that may have resulted from e-cigarette use, in accordance with new World Health Organization disease classification codes.

Health Secretary Francisco T. Duque said the health care industry must “use proper codes for designating vaping-related disorders to allow the existing health information systems to capture data on vaping-related disorders.”

The World Health Organization has introduced International Classification of Disease 10 code U07.0 which will be used to monitor disease of patients who have used e-cigarettes in the last 90 days, “with no other plausible causes for illnesses.”

“Information on the potential harm of novel and emerging nicotine products can guide future policy directions for electronic cigarettes,” Mr. Duque said.

Mr. Duque also cited a report by the US Centers for Disease Control and Prevention that the US has documented 1,299 illnesses and 26 deaths determined to be vaping-related.

Meron siyang classification…Kung wala siyang infection, walang siyang ibang sakit tapos acutely ill siya pagkatapos siya ay gumamit ng e-cigarettes or vapes for the last 90 days, then ‘yun na ‘yung diagnosis niya (The classification for patients with no infections or other illnesses who become acutely ill and who have used e-cgarettes or vapes in the last 90 days) is vaping-related illness,” Undersecretary Rolando Enrique D. Domingo said.

Mr. Domingo said the department and the Food and Drug Administration is requiring all hospitals to report all e-cigarette and vaping-use associated lung injuries (EVALI).

The DoH also urged all health professionals to be “vigilant” in identifying risks during routine clinical evaluations by taking the history of patients’ use of tobacco or e-cigarette.

“Electronic cigarettes and heated tobacco products are sold in the market as alternatives for smokers trying to wean themselves off tobacco. Some studies claim that they contain fewer chemicals and are less harmful alternatives to cigarettes. We do not support their claim of reduced harm. These products endanger the health of both users and non-users, and are clearly not meant for children,” Mr. Duque said.

Ma. Encarnita C. Blanco-Limpin, a medical doctor and secretary of Philippine College of Physicians, said e-cigarettes should be prohibited and not just regulated as they are “not safe, in fact can kill.”

“It is now time for us not just to think about regulation, it is probably time for us to think about prohibiting such deadly products. It will be probably irresponsible for medical practitioners not to think of prohibition knowing that it can cause death of even just one individual,” she said.

A measure that will further increase excise taxes imposed on electronic cigarettes and vaping products is pending in the 18th Congress.

The proposal, which will amend Republic Act No. 11346, introduced the following rates on vapor products: P10 on 10 milliliter vapor products, P20 on 20 ml, P30 on 30 ml, P40 on 40 ml, P50 on 50 ml and so on.

The House of Representatives, in House Bill No. 1026, proposed to increase rates to P45 per pack beginning January 2020, which will be at par with rates imposed on regular tobacco products. This is to increase by P5 annually until 2023.

The bill further provides a tax rate for vapor products containing nicotine salts, will increase by P5 every year from P30 in 2020 until it reaches P45 in 2023.

In Senate Bill No. 1074, the chamber proposed similar rates for heated tobacco products, but provided higher rates on vapor products with nicotine salts or conventional forms of nicotine.

If enacted, the bill will impose a P45 per 10 milliliter charge by January on vapor products with nicotine salts or conventional forms of nicotine, increasing by P5 per year until it reaches P60 in 2023.

Mr. Domingo said registration for retailers of e-cigarettes has been suspended after a Pasig City regional trial court imposed an injunction in response to a retailer’s questioning of the constitutionality of DoH Administrative Order (AO) 2019-0007 issued in June.

A separate case has been filed in a Manila court.

The AO required makers, sellers, and distributors of electronic nicotine and non-nicotine delivery system to apply for a license to operate with the Food and Drug Administration.

Mr. Domingo said 152 have applied and some granted a license to operate, mostly retailers. “Others we have to put on hold.”

He called the injunction a “temporary setback” but added: “It doesn’t preclude us from spreading the facts surrounding the use of such a harmful product. So we will go on doing that.” — Vann Marlo M. Villegas