A comprehensive commentary made by a U.S. Food and Drug Administration (FDA) official in an international peer-reviewed publication recommends a switch from combustible cigarettes to smoke-free products to reduce the exposure of adult smokers to many toxins and carcinogens.

Dr. Lorenzo Mata, president of Quit for Good, a harm reduction non-profit group.

This, according to consumer advocacy groups in the Philippines, proves that tobacco harm reduction (THR) products such as vapes, heated tobacco, and nicotine pouches could serve as better alternatives to cigarettes.

Smoke-free products emit aerosols or vapors that contain 95 percent less harmful chemicals than smoke produced by burning tobacco. Aerosols are formed through heating at a much lower temperature than the burning process, resulting in a much smaller number of constituents compared to smoke.

"Nearly a million former smokers in the Philippines have already switched away from smoking, and with the recent FDA-CTC commentary, we expect more smokers to understand the huge difference and transition to less harmful alternatives," Dulay said.

Dulay was referring to a commentary co-authored by Dr. Brian King, director of the FDA’s Center for Tobacco Products (FDA-CTP) and published in the peer-reviewed medical journal Nature Medicine that discusses the relative risks of different tobacco products for healthcare providers.

The commentary, titled "Nicotine e-cigarettes: Considerations for healthcare providers," says that "non-combustible tobacco products, such as e-cigarettes, generally have lower health risks to the user than combusted tobacco products."

It cites findings from the U.S. National Academies of Sciences, Engineering and Medicine (NASEM) that switching completely from cigarettes to e-cigarettes reduces exposure to many toxins and carcinogens.

"The Philippine Congress also acknowledges the role of these smoke-free products in providing Filipino smokers with alternatives when they enacted the Vape Law in 2022 to regulate vapes and novel tobacco products," Dulay said.

The FDA-CTC commentary encourages healthcare providers to educate adult smokers who have unsuccessfully tried quitting methods about the potential benefits of switching to lower-risk alternatives. It emphasizes that complete cessation remains the best course of action and that FDA-approved cessation medications should be the first-line treatment.

"Nicotine itself isn't the problem, but how it's delivered through combustion," said Anton Israel, president of the Nicotine Consumers Union of the Philippines (NCUP). "Smoke-free products allow smokers to significantly reduce their exposure to toxic chemicals."

Dr. Lorenzo Mata Jr., a Filipino tobacco harm reduction advocate, urged medical professionals to weigh the FDA-CTP commentary.

"We should study how these less harmful nicotine alternatives can help Filipinos quit smoking based on scientific evidence," said Dr. Mata, president of the harm reduction non-profit Quit for Good.

The other co-authors of the commentary are Dr. Benjamin A. Toll of the Medical University of South Carolina's Department of Public Health Sciences and Dr. Tracy T. Smith of the university's Department of Psychiatry and Behavioral Sciences.

The commentary also noted that "misperceptions among physicians and other healthcare professionals may lead to patient counseling that is not consistent with existing scientific evidence." It said these misperceptions are associated with lower odds of smokers completely transitioning to e-cigarettes.

For adult smokers who have unsuccessfully tried proven cessation methods, medical providers may consider educating patients about the relative risks of tobacco products and the potential health benefits of switching completely to a lower-risk product, the commentary said.