Innovative tools vs. old scourge

We've codified our existence to bring it down to human size to make it comprehensible,we've created a scale so we can forget its unfathomable scale. -- Lucy

Epidemics come and go.

But not without leaving a devastating toll at their wake.

Some linger longer than the rest, like the still-raging 2019 coronavirus disease pandemic.

Covid-19 has been around for almost six months, and no significant breakthroughs have been achieved toward developing a vaccine,  It was  officially declared a pandemic by the World Health Organization announced on March 11.

"This is the first pandemic caused by a coronavirus," WHO Director-General Tedros Adhanom Ghebreyesus said then. It was also the first time the WHO has called an outbreak a pandemic since the H1N1 "swine flu" in 2009.

The Department of Health on Tuesday reported 1,678 new Covid-19 infections, raising the overall tally to 83,673.

It also reported 173 new recoveries and four deaths. These figures bring the total number of recoveries to 26,617 and the total number of deaths to 1,947.

But there is an older, more pernicious scourge that has been around far longer than Covid-19.

Unlike the pesky pandemic, however, there is now a way out, an escape hatch for this old scourge – smoking.      

In an industry-shaking, lifestyle-enhancing move, the US.. Food and Drug Administration has authorized the  marketing of IQOS as a modified risk tobacco product.

And this should encourage other countries such as the Philippines to take a second look at innovative products as effective means to eradicate the smoking epidemic, according to two public health experts.

Prof. Tom Glynn, an adjunct lecturer at Stanford Prevention Research Center and a former director of International Cancer Control at the American Cancer Society in Washington D.C., said heat-not-burn tobacco products such as IQOS, electronic cigarettes, and other less harmful products provide smokers with better alternatives to cigarettes.

Studies showed that smoking results in 100,000 deaths in the Philippines each year.

"More than 100,000 Filipinos die from cigarette smoking each year. Globally, more than seven million people die from cigarette smoking annually. Cigarettes, when lit, produce more than 7,000 chemicals, at least 60 of which can cause cancer. For more than 50 years, as the scientific and medical evidence about the dangers of cigarette smoking has accumulated, Filipino cigarette smokers, and cigarette smokers around the world, have been urged to quit their use," said Glynn, a widely-published consultant on cancer and tobacco use prevention and control.

Glynn said with the tobacco smoke being blamed for diseases and death of millions of smokers each year, less harmful products have been developed over the years, including e-cigs, Swedish snus, and HTPs. 

"The common thread among these products is that they offer a less harmful way of inhaling nicotine, the primary chemical that keeps smokers dependent on their cigarettes," he said.  

"Many public health experts believe that, by substituting these less harmful products for cigarettes, smokers can also reduce their vulnerability to the illnesses, and death, associated with cigarette smoking."

He said one of them is IQOS, developed by Philip Morris International which received the authorization from FDA on July 7, 2020.

This allowed PMI to communicate the “reduced exposure” claim of IQOS, compared to cigarettes.  The authorization is the first and only for any existing electronic nicotine product.

As of March 31, 2020, some 10.6 million adult smokers around the world have already stopped smoking and switched to IQOS, according to PMI.  The company expects a total of 40 million smokers to switch to IQOS by 2025.

"This is a significant advance for public health in the US, and globally, if other countries follow this lead (and some already have), since it offers smokers another opportunity to finally quit their cigarette use and its attendant death and disease," he said.

"While the FDA was careful to avoid implying that they have approved IQOS for use, instead simply saying that the product produces significantly less harm than cigarette smoking, the FDA action does promote its long-standing position that there is a "continuum of risk" among nicotine-containing products and that IQOS is positioned well below cigarettes in that continuum," said Glynn. 

"This action is good for public health—smokers need less harmful alternatives to deadly cigarettes. Of course, it is vitally important to ensure that these IQOS and other nicotine-containing products do not become used by children and youth, and the FDA has taken, and will continue to take, strong actions to ensure that this does not happen," he said.

The MRTP authorization shows that IQOS is a fundamentally different product than combustible cigarettes, and must be regulated differently, as the FDA has recognized.  

The FDA’s decision is consistent with earlier conclusions of other leading regulatory and scientific bodies, including in the UK, Germany, and the Netherlands, which have found that the product emits lower levels of harmful toxicants. 

 Prof. David Sweanor, a public health policy expert who chairs the advisory board of the Center for Health Law, Policy and Ethics at the University of Ottawa, said this is because it has been known since the 1970s that smoke, not nicotine, causes thousands of deaths among cigarette smokers each day.

"The science has clearly shown that it is the toxins in smoke rather than the nicotine that causes the harm. We have also seen many examples of the ability of smokers to switch to smoke-free alternatives, including in our recent research on Japan where the availability of HTP has led to a massive decline in cigarette sales," Sweanor said.

"Technology allows us to eradicate the pandemic of cigarette-caused disease. It is a matter of whether regulators can seize the opportunity. Also, whether an ironic combination of tobacco companies and abstinence-only anti-nicotine groups can be prevented from protecting cigarettes from disruptive technologies," he said.

Behold God’s glory and seek His mercy.

Pause and pray, people.