Evidence from Institute-Led Studies in the Philippines Spurs Calls for Action

The body of evidence from multiple Institute for Global Tobacco Control (IGTC) research initiatives conducted in the Philippines has resulted in calls for stronger policy measures by the country’s news outlet of record.  

The timing of the publication—a three-part series in the Philippine Daily Inquirer detailing IGTC’s work examining young consumer perceptions, studying flavor chemicals, and analyzing online marketing and the sale and marketing of cigarettes, e-cigarettes, and heated tobacco products (HTPs) near Filipino schools—coincided with a request by Health Secretary Teodoro Herbosa for stricter enforcement of regulations preventing minors from accessing nicotine and tobacco products.  

The first article, “Flaws in law worsening youth ‘vapedemic’” highlighted data from IGTC’s surveillance study of point of sale marketing—which found 2,070 cigarette vendors operating within 100 meters of 276 schools—as proof that current regulations and enforcement are insufficient. Quoted for the story, IGTC assistant scientist Jennifer L. Brown, PhD, said, “Filipino law forbids the sale and advertising of cigarettes, e-cigarettes, and HTPs within 100 meters of schools and mandates clear signage about age restrictions. Adhering to these regulations is essential to shield young people from the dangers of tobacco.” 

Part two, “E-cigarette, vape marketing lures PH youth,” referenced three different IGTC studies exploring flavors in nicotine and tobacco products: One examined young Filipinos’ perceptions of flavored cigarette packs, in which some focus group participants stated that the products “look[ed] like a candy” and had colorful imagery that would be “appealing to the younger ones.” Another analyzed flavored tobacco products sold in the Philippines to assess the presence, levels and mix of flavor chemicals that can be manipulated by manufacturers to maximize potential consumer appeal. The third studied online marketing of e-cigarettes and HTPs on brand websites in the Philippines, concluding (among other findings) that youth-appealing text and imagery conveying flavors were common across all sites. Individually and collectively, the evidence supplied by these studies supports a strict ban on flavored nicotine and tobacco products as well as restrictions on the use of imagery, descriptors and colors that can connote flavors.  

The Inquirer’s final installment, “Tougher measures needed to protect PH youth from ‘vapedemic,’” described the limited effectiveness of the Vaporized Nicotine and Non-Nicotine Products Regulation Act (RA11900) due to shortfalls in its enforcement and tobacco industry non-compliance with the law—youth-targeted marketing being one prominent example. 

“There is ample evidence showing that tobacco companies employ various strategies to promote their products, aiming to attract the attention of children and young individuals,” explained IGTC senior research program coordinator Elizabeth Crespi, MPH, in an interview for the article. “[These include] positioning displays at eye level for kids, ensuring the availability of products and advertisements in proximity to schools, parks, and other areas frequented by children, and utilizing eye-catching packaging with enticing flavors to make products appear novel and appealing.”  

Crespi and her fellow researchers explained that evidence-based policies, together with strong enforcement and imposing strict penalties for violations, can help prevent people from starting to use tobacco products and support those who are addicted to nicotine and want to stop.  

In addition to a comprehensive advertising ban that prohibits marketing at the point of sale, IGTC assistant scientist Tuo-Yen Tseng, PhD, offered several additional policy interventions that could effectively counter the tobacco epidemic in the Philippines: “Restoring the minimum purchase age to 21, prohibiting flavors [or] additives other than tobacco flavor, applying plain and standardized packaging, and prohibiting health and cessation claims unless evaluated and approved by a specialized government health agency to protect Filipino youth from tobacco and nicotine harm.” 

With mounting evidence to support the media attention, work of advocacy groups, and calls for heightened enforcement by the Department of Health, could it be enough to compel a response from Filipino policymakers? Dr. Brown believes that these evidence-based policies are key to saving 100,000+ lives each year in the Philippines.  

“We have evidence that policies, like 100% smoke-free public places, comprehensive advertising bans, prohibiting flavors, and raising tobacco taxes, can help prevent people from starting to use tobacco products and support those who are addicted to nicotine and want to stop,” she said. “With the necessary political will behind them, countries around the world have successfully adopted strong, national-level tobacco control policies that protect [their] residents from tobacco-caused death and disease.”