Heart expert sees e-cigs, heated tobacco as best solution to reduce harm from smoking


Smoke-free alternatives such as vapes and heated tobacco products (HTPs) can drastically reduce the exposure of millions of Filipino smokers to harmful substances and help them eventually quit, according to a leading heart specialist.

 Dr. Rafael Castillo

Dr. Rafael R. Castillo, who spoke in a recent satellite symposium during the annual convention of the Philippine Heart Association (PHA), said smoking problem is a serious challenge that is worse than the Covid pandemic.

“Smoking is also the number one risk factor for cancer in the Philippines. Smoking is a serial killer that kills so many people,” he said in a virtual discussion during the 70th anniversary and 52nd annual convention and scientific meeting of PHA.

Dr. Castillo, the first Filipino and Southeast Asian to be elected as a trustee of the International Society of Hypertension (ISH), said that while traditional approaches have failed to address the smoking epidemic, the introduction of smoke-free alternatives that produce vapor, instead of smoke, has been associated with less health risks, may be the most effective solution to address the problem.

“While the use of alternative tobacco products does not completely eliminate the harm, they can significantly reduce or mitigate the health risks. Personally, I believe that this is the best bet of all currently available smoking cessation measures to help recalcitrant smokers really kick the smoking problem, not only in our country but worldwide,” said Dr. Castillo, the past president of the Philippine Heart Association-Philippine College of Cardiology and the Asia Pacific Society of Hypertension.

He said smokers deserve a viable alternative that can wean them off cigarette smoking, and help them quit. Tobacco harm reduction strategy, or the use of these less harmful alternatives to cigarette smoking, will help smokers improve cardiovascular and other health outcomes, he said.

Dr. Castillo said that while quitting smoking remains the primary goal, for recalcitrant smokers or those who can’t quit despite smoking cessation interventions, “the use of electronic nicotine delivery systems or alternative tobacco products may serve as a pragmatic middle ground to reduce harm and eventually make them quit completely.” “With all the heartbreaking failures we had in making recalcitrant smokers kick the habit, we have to face reality. We have to offer recalcitrant smokers alternatives and give them more tools. Smoking addiction is not something that they cannot simply overcome. We have tried all sorts of smoking cessation interventions (patches, nicotine gums, etc.), but we are not getting anywhere. We are not really progressing as much as we would like to,” he said.