Don’t ape the vape
Alam ninyo po ang tuklaw? “This was a question posed to me by a 12-year-old who came for a consult because of hearing loss in his left ear. You may be wondering how this question became part of our conversation. As a doctor, history taking doesn’t just center around a patient’s chief complaint and the factors surrounding it, but involves a review of a patient’s social history, including risk-taking behaviors, such as drug or alcohol use. I shook my head and said that I didn’t know, but it sounded ominous. He looked at me and cheerfully replied, “I-Google mo.” Showing him the results, it turns out that “tuklaw” is a tobacco plant that originates from the mountains of North Vietnam and can be smoked or chewed. Its nicotine content is higher compared to that of a regular cigarette, and according to laboratory findings of the Philippine Drug Enforcement Agency, it also contains a synthetic cannabinoid. In recent months, there have been reports of teenagers who reportedly smoked these cigarettes and presented with seizure-like symptoms, prompting public warnings from concerned agencies.
While he claimed to not have taken the illicit drug, smoked it, or vaped, he admitted that he has been exposed to it in his current environment. The ensuing recount of what he witnessed succeeded in stirring a mix of emotions. While disappointment and frustration were the ones that first came to mind, the resolve to increase awareness about this global threat eventually superseded them.
Smoking—whether with the ordinary or the electronic form—doesn’t diminish its harmful and lethal effects. The most enduring marketing messages regarding vaping include being a safer alternative because it is less potent, and as a means to help quit smoking. In a recent study by the Institute for Global Tobacco Control at the Johns Hopkins Bloomberg School of Public Health, the targeted market is the youth.
In an activity with a local government unit last Friday, a known leader in community pediatrics shared that in a study they are currently conducting in two schools, around 50 percent of youth are into vaping. Since statistics never fail to impress, to give an idea of how worrisome the problem is, in a paper by Serra et al. from the Philippines Global Youth Tobacco Survey in 2019, analysis of 6,670 students in the age group of 13-15 years showed that the prevalence of e-cigarette use was 14.1 percent, ever-use was 24.6 percent, and awareness was 75.5 percent. Furthermore, current use was associated with the use of other tobacco products and exposure to secondhand smoke at home, in school, and in public places.
These pieces of information are troubling. While there have been well-documented long-term effects of smoking, such as cancer, increased risk for cardiovascular disease, and other respiratory illnesses from impaired lung function, the one thing that is not given as much mileage is its effect on neurodevelopmental function. For a generation already navigating enormous pressures, this is a harm we cannot afford to overlook.
So how do we help? To give credit to those who are committed to providing solutions, there are existing policies and bills that have been put in place because of their efforts. However, these need to be further strengthened, and from the current state of events, we do not have the luxury of time to wait before change can be instituted.
One of the most effective strategies in any advocacy effort is to provide knowledge and awareness. This has long been the most powerful tool available to the medical community. The question that always demands an answer is: To what extent does education actually influence a change in behavior?
In a yet unpublished local research study examining the impact of an anti-smoking/anti-vaping educational module among secondary school students, results showed that despite its limitations due to a small sample size, there was an improvement in perception and a deeper understanding of the risks involved, as well as strengthened intentions to avoid vaping and smoking. However, the module had limited impact on current users, highlighting the need for earlier and more frequent interventions.
Reading through the recommendations, two stand out as particularly critical: moving away from didactic approaches toward more creative and engaging learning methods and ensuring active family involvement. Research consistently shows that children who smoke almost invariably have a parent or caregiver who smokes as well. For current users, the recommendations center on strengthening cessation support and offering alternative stress management activities.
The window to act is narrowing. What remains is the only question that has ever mattered in public health; not what we know, but what we are willing to do about it.
If we mean to contribute to solving the many problems that we face, we must be convinced to do what we can in whatever capacity and we must do it now.
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timgim_67@yahoo.com
