A 16-year-old girl from Central Visayas is the country’s first known victim of lung injury caused by electronic cigarettes (e-cigarettes), or vaping, the Department of Health (DOH) said on Friday.

Health Secretary Francisco Duque III said the first recorded e-cigarette, or vaping, product use-associated lung injury (Evali) patient was not asthmatic but had been using an e-cigarette daily for four months since March. She then started smoking both the device and traditional cigarettes until she was hospitalized on Oct. 21.

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Two weeks prior to her hospitalization, Duque said, the girl, who was not identified, took cough medicines to help relieve her dry cough but to no avail.

The patient was brought to an undisclosed hospital after she had a “sudden onset of difficulty of breathing,” he said.

The DOH said that she “met the case criteria for Evali” based on guidelines provided by the US Centers for Disease Control and Prevention (CDC).

The CDC has recorded at least 2,172 cases of lung injuries and 42 deaths associated with e-cigarettes and vaping.

On its website, the CDC said patients with Evali reported such symptoms as coughing, shortness of breath, vomiting, fever and weight loss. It noted that some patients reported that their symptoms “developed over a few days or over several weeks.”

The patient was discharged after six days in the hospital and as of Nov. 7 she was “well with no recurrence of symptoms,” Duque said, adding that she has also stopped smoking.

Her pulmonologist was in “continuous communication” with the DOH for updates regarding her condition, he said.

Health Undersecretary Eric Domingo said this case further strengthens their assertion that “no e-cigarette product should be accessible to young children and adolescents, who are uniquely susceptible to the harms of e-cigarettes and nicotine.”

“All e-cigarette users should seek immediate medical help, and ask their doctors for ways to quit these harmful products. I urge nonusers not to even try e-cigarettes at all,” Domingo said in a statement.

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On July 4, the DOH issued Administrative Order No. 2019-007 to regulate the use, sale and distribution of e-cigarettes in the country. The order strictly prohibits e-cigarettes from being sold to or purchased by minors.

A company called Green Puff and a petitioner Ryan Sazon, both distributors of e-cigarette juice and kits, challenged the implementation of the AO. They obtained temporary restraining orders last month from the regional trial courts in Pasig and Manila to stop the DOH and the Food and Drug Administration from exercising their regulatory functions over e-cigarettes.

A step backward

Domingo said the DOH hoped that these court cases would be resolved “with utmost urgency,” stressing that “every delay in regulating e-cigarettes is a step back for public health.”

The e-cigarette industry is claiming that its products are alternatives to tobacco and a tool to quit smoking.

The World Health Organization (WHO) disputed the claim, saying there has been no systematic evaluation of e-cigarettes that could prove that. WHO instead found that tobacco smokers just became e-cigarette smokers or dual users, like the Visayas patient.

Physician and Sin Tax Coalition coconvener Anthony Leachon said the first Evali case should push lawmakers to immediately pass a proposed measure to raise taxes on e-cigarettes.

“This is a cause for great concern, and we hope that the government steps up and protects the public from the harmful effects of the use of e-cigarettes and vape before this becomes a large-scale epidemic,” Leachon said.

The Senate is deliberating on a bill, which has been certified urgent by President Duterte, to raise the excise on e-cigarettes and other heated tobacco products (HTPs) to help generate funds for the universal health care program.

Under the proposed measure, the tax rate for HTPs and vapor products will be pegged at P45 starting next year, and will be raised by P5 each year till it reaches P60 in 2023. A 5-percent annual increase will be imposed thereafter.

In a nationwide Global Adult Tobacco Survey in the Philippines by WHO in 2015, 2.8 percent of respondents said they have tried vaping or smoking e-cigarettes and 0.8 percent said they were current users.

The highest users were among the 15-24 and 25-44 age groups.

The same survey said tobacco use prevalence among Filipinos was 23.7 percent, higher than the global average but down from 29.7 percent in 2009.

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