A Greek cardiologist and top harm reduction expert asked the Philippine government to regulate, and not ban, the use of electronic cigarettes to help smokers quit the habit and save them from premature death. Dr. Konstantinos Farsalinos, a researcher at Onassis Cardiac Surgery Centre in Athens, says other countries are in fact lifting the ban on vaping—the act of inhaling and exhaling the vapor produced by an electronic cigarette which is a battery-operated device that vaporizes a flavored liquid made of nicotine, propylene glycol, glycerine and flavorings. “The trend today is to lift the ban, not to implement the ban,” says Farsalinos who managed to quit a 36-year habit of smoking by switching to e-cigarettes seven years ago. “Switzerland and Belgium used to ban nicotine-containing products but now they have lifted the ban. New Zealand is now actively encouraging the use of e-cigarettes and they are changing the legislation. The same is happening in Canada, which is the only country in the world where the e-cigarette packaging is going to have an encouragement label that this product is less harmful than smoking,” he says in an interview in Makati City where he spoke during the 50th Annual Convention and Scientific Meeting of Asia Pacific Society of Cardiology 2019 Congress. Farsalinos advised countries to look at the European example. “Europe is the only region in the world with a comprehensive and fully implemented regulation on e-cigarettes for the past three years since 2016. This could be a good starting point for every country in the world to use this as a basis and adjust the regulation based on their local, unique characteristics,” he says. He says among countries, the UK has the strongest support for electronic cigarettes. “The problem comes from the lack of regulation. In countries where you don’t have any regulation, you don’t have any control. We fully support the need for regulation because all consumer products are regulated. We want smokers to use them [e-cigarettes] in an effort to quit smoking,” he says. The Philippine government reportedly considers imposing a ban on e-cigarettes. “It does not make sense at all. It communicates a very misleading message to the population. Basically, they are actively discouraging smokers from trying this alternative effort to quit. They create a mistrust on the product,” says Farsalinos. “It is a decision out of fear for the unknown,” says Farsalinos. Fortunately, he says the scientific community has already gained a large body of evidence on e-cigarettes over the years. “The duty of the politician is to ask for advice from people who have been involved over the years in this field of research,” he says. Farsalinos says that based on voluminous studies, the use of e-cigarettes is substantially less harmful than burning tobacco which releases carcinogens like formaldehyde, acetaldehyde and acrolein. Public Health England reported in 2015 that e-cigarettes are 95-percent less harmful than smoking, as the harmful chemicals present in cigarette smoke are either not in EC vapor or only found at much lower levels.Farsalinos warns that a ban on e-cigarettes will only create an underground industry that is not regulated and without quality standards. It will also exacerbate the problem of smoking which is ironically allowed, he says. Heneage Mitchell of consumer advocacy group Fact Asia Consultants Ltd. says regulation is also needed “to restrict the sale of e-cigarettes to minors, so they cannot buy it.” Farsalinos agrees, saying e-cigarettes should be promoted only to existing smokers to help them quit the harmful habit. Harm reduction advocates explain that people die from tar, or the byproduct of burning cigarettes, and not from nicotine. The World Health Organization says smoking kills more than 7 million people each year, making the tobacco epidemic one of the biggest public health threats. WHO, however, does not endorse vaping. “WHO itself predicted that premature deaths from smoking would increase to 8 million annually and in the whole 21st Century we are going to have 1 billion premature deaths because of smoking,” says Farsalinos. Farsalinos says with proper regulation and quality standards, e-cigarettes are much less risky to humans because they contain food-grade and pharmaceutical-grade products. He says nicotine is not the culprit, because even WHO allows the use of nicotine gums and nicotine patches as a tool to quit smoking. He describes e-cigarettes and heat-not-burn tobacco as a group of harm reduction products that will improve and reduce the risks of diseases among smokers. “It is a choice that has a direct effect on their health,” he says. “In 1986, WHO made a declaration that clearly mentioned that people all over the world should have proper and balanced information and should be provided all the tools available to improve their health,” says Farsalinos, adding that e-cigarettes proved effective in making smokers quit the vice. “In my opinion, by depriving the smokers of the choice of less harmful alternative while the governments all over the world allow the sale of cigarettes which is the most lethal product, I think we have a problem there,” he says.