SIMON TAKES a deep breath. Smoke enters into his lungs, reaching every sinew. He slightly raises his head, and a thick cloud of vapor billows out of his mouth.
One would expect to see a half-used cigarette emitting wisps from its embers. But instead, the smoke was blown from a neon-colored cartridge tucked between Simon’s fingers.
He just turned 20 this year and had already been vaping since ninth grade, about five years ago. Now, Simon spends his days passing through Dapitan Street and into the halls of the St. Raymund de Peñafort building to attend his classes as a second-year Legal Management student of the University. In between classes, he treats himself to a promenade in tight alleyways near the campus. There, voices gather in circulating mists.
“I was a smoker before I started vaping,” Simon told The Flame. There was a hint of a rasp in his voice.
Republic Act No. 11900, or the Vaporized Nicotine and Non-Nicotine Products Regulation Act, regulates the manufacture, sale and use of vaporized nicotine and non-nicotine products. It sets the minimum age for purchasing these items at 18 years old. This is a far cry from when Simon began his vices. And yet, he is not an outlier.
James, aged 14, was younger than Simon when he first tried vaping. It was last year when he took his first huff, using a vape that belonged to his friend.
Seeing them, James developed the urge to try it.
“They said it wasn’t bad,” he said.
James was not able to get vapes of his own and frequently borrowed from his friends who, according to him, bought them “illegally.”
“It’s refreshing,” he said, referring to vaping. “When you inhale it, it feels cool inside your lungs and its passageways of air.”
Vapes and e-cigarettes were first introduced to the market as a means of helping chronic cigarette smokers break free from their addiction. They give the same sensations while reducing health risks and separating smokers from the habit of lighting a cigarette.
From being therapeutic mechanisms for quitting an addiction, these devices have risen in popularity among non-smokers. In recent years, they have become favorites among young people.
The 2019 Global Youth Tobacco Survey indicates that one in every seven Filipino students aged 13 to 15 is using e-cigarettes daily. This range is within the younger bracket of Generation Z, or those born between 1997 and 2012, aged 12 to 27 years old.
It runs in the family
Simon’s earliest memory of cigarettes is tied to the image of his relatives. As a young boy, he wandered the halls of his home while family members filled the air with smoke.
“I thought they smelled great. I was always confused why a lot of people would move away when a group of men would light a stick,” he said.
Cinders piled up in the ashtrays as the adults leisurely talked.
“The smell would always draw me closer. It goes without saying that it made me want to try some for myself.”
Another influence traces back to 2011. Simon was barely in elementary when his family moved — which they often did — to a subdivision in Caloocan.
In this fresh environment, Simon found himself spending afternoons with the kids in his neighborhood. They passed around cigarettes and borrowed lighters among themselves. His eyes traced the curling smoke they blew from the burning sticks. An urge to explore this unfamiliar territory flickered.
“I would hang out with them,” he said. “After a few months, I asked them to teach me how to smoke cigarettes.”
He took a stick from his friend, got it lit and stuck it between his lips before breathing it all in.
“First stick, naubo ako, and ang hirap ipasok sa lungs, so puro hanggang mouth lang (I coughed at my first stick and had difficulty making the smoke enter my lungs, so it only reached my mouth),” he said.
He remembered feeling a sense of warmth rushing through him shortly after, and, as he looked around to see his pals doing the same, he felt like he belonged.
“It was cool — and that was partly the reason,” Simon said. He shook his head, reminiscing the moment.
“I’m not ashamed to admit that. I can tell you that most smokers of cigarettes and vape do it to look cool.”
That is how he began puffing cigarettes as young as seven years old.
What started as a few sticks quickly spiraled into two or three packs a day. But earlier this year, Simon made the decision to quit his habit by fighting fire with fire: a vice for another.
The shift to vaping
By the time Simon reached high school, he and his family had moved to the province of Isabela. New place, new faces, new friends — yet the same old pastime troubled Simon.
When he and his friends first hung out, he noticed they had no lighters and cigarette boxes.
In their hands were mini boxes made from brightly colored plastic. The end of its body was a mouthpiece, and when one of his friends took a hit, sweet clouds of vapor floated around them.
Simon was already aware of e-cigarettes by then. He had seen the non-disposable ones — compact and heavy, filled with batteries, coils and cotton. At first, he had no interest. He was comfortable and content with his Marlboro Lights. But as he watched his friends use their vapes, curiosity began to creep in.
“That made me think, Why weren’t they smoking cigarettes? Why did they prefer vapes?” he said.
Simon gave it a whiff, and the familiar sensation that cigarettes once provided flooded his lungs; but this one, he thought, had a pleasant, saccharine taste and had thicker clouds.
“It was comforting,” Simon recalled.
Soon enough, he found himself getting his own vape. Vaping was an easier way to chase the sensation cigarettes gave off without the hassle of lighting a stick, only to then worry about its stinging aroma.
“I was still smoking cigarettes while I was vaping,” Simon said.
“It wasn’t really a transition. It didn’t mean I stopped smoking — the smoking of cigarettes only lessened,” he added.
Five sticks a day became three and, eventually, just one. He had only stopped smoking cigarettes very recently.
Having indulged in both vices for years, Simon had gained a deep understanding of the ins and outs of the vaping industry and the people who consumed it. He would later open his own vape shop in his province.
Over the years, he found himself drifting away from the thrill of fitting in. It transformed into something deeper. When stress and anxiety loomed large, feeling the cool, sweet vapor fill his lungs lifted the weight off his shoulders.
“Some of the users, including myself, do it because they need to deal with problems,” Simon said.
“I remember the feeling of smoking whenever I had a problem. I remember feeling fine, less anxious, more relaxed. I thought, Why not do that again?”
Vaping, he said, gives similar effects.
Safer alternative?
Many go as far as to claim that vaping is a safer alternative to cigarette smoking. One of the believers of this notion is Simon.
“I was shown evidence before by a cousin,” he recalled.
It was around the time Simon was contemplating quitting cigarettes and fully transitioning to vaping. They were deep in conversation about his decision, and his older cousin no longer wished for Simon to damage his health further.
The cousin pulled out his phone. After a few swipes, the screen showed two chest X-rays. They belonged to their friends: one who vaped frequently but had never smoked cigarettes and another who exclusively used tobacco.
Simon leaned closer, studying the images. From the pictures, the friend who vaped looked like he had healthier lungs, in contrast to the one who smoked. He was convinced.
“From what I’ve seen, I think vaping is safe. Those people my cousin told me about are real people. It wasn’t something he made up. They’re people I know.”
A number of sources have supported the notion that vaping is relatively safe. For instance, data from a 2015 evidence review published by Public Health England suggests that vaping is 95% less harmful than conventional cigarettes. The review consolidated evidence from 94 papers and nine additional news reports, with a particular focus on the United Kingdom.
“While vaping is generally known to be a less harmful alternative to smoking due to fewer toxins, it still has health risks, and its long-term impact generally remains unclear,” Dr. Ma. Celina Guillermo, a practicing physician and part-time faculty member from the Ateneo School of Medicine and Public Health, told The Flame.
In May, a 22-year-old male was admitted to the Philippine General Hospital along Taft Avenue due to sudden chest pain. A week before, he had been coughing up blood. He had a fever and was vomiting. He had never touched cigarettes or even drugs, but he used vapes for two years straight.
Although he had no known health issues prior, the patient died from a heart attack. A case report published in April concluded that the heart attack was associated with an e-cigarette or vaping product use-associated lung injury, or EVALI. It was the first case of its kind recorded in the Philippines.
In recent years, reports of EVALI cases have been growing in other countries. In the United States, there were 2,807 cases documented by the Centers for Disease Control and Prevention.
The Department of Health (DOH) rejects the claim that vaping is safer than cigarette smoking and has been warning the public about the risks associated with the habit.
“E-cigarettes and vaping are not a safe alternative to smoking. They still produce harmful smoke,” DOH Secretary Teodoro Herbosa was quoted by a Philippine News Agency report as saying.
The health chief described the claim that vaping is a safer smoking alternative as “false advertisement.”
Herbosa also urged the Philippine National Police to implement the law and ensure that no minors would have access to vaping. Vendors should also strictly follow the restriction against the sale of vape products to minors, he added.
Already an epidemic?
As early as 2021, the DOH has been sounding the alarm over the growing popularity of vaping among young Filipinos.
According to the agency, data showed a 110% increase in vape use in just four years from 11.7 percent in 2015 to 24.6 percent in 2019.
The DOH also cited a study by the Philippine Pediatric Society and the Department of Education suggesting that the age of initiation of using electronic cigarettes starts at 10 to 15 years old.
The trend is “concerning” because several studies noted that the brain’s prefrontal cortex, which is involved in executive and decision-making functions, continues to mature until about the age of 25, the health department added.
Guillermo is convinced that the country is experiencing a “vaping epidemic.”
In her research article, Guillermo wrote about how the Philippines may face an “uphill struggle” due to the influence of commercial determinants alongside government policies.
Policies on vaping have recently changed. Previously, the minimum age for access to vapes was set at 21. But, in 2022, the Vaporized Nicotine and Non-Nicotine Products Regulation Act lowered the minimum age to 18, along with other changes such as allowing online advertising and promotions.
The law also shifted regulatory authority from the DOH to the Department of Trade and Industry. Stripped of its status as medicinal goods, DOH-sanctioned restrictions on e-cigarettes, vapes and other related products were relaxed.
“With social media, there is constantly a danger of disinformation, making vaping more accessible to youth through commercials and e-commerce without highlighting health consequences,” Guillermo told The Flame.
“In instances where I encounter young patients who are vaping, they are often influenced by their peers or drawn to the habit due to cultural norms and product accessibility,” she added.
Simon knows this too well.
“It’s not the flavor, how the vape looks, how much it costs or the availability. It’s the fact that they see it everywhere,” he said, referring to the endless stream of vaping-related content that can be found online.
Young impressionable minds often catch glimpses of social media influencers wearing their vapes with lanyards or even puffing them as they go on about their business. Some nonchalantly take a whiff, or hipak, off their cartridges before replicating a dance craze.
“They take pictures of themselves and post it on their story on Instagram or Facebook holding vapes,” Simon said.
Like a domino effect, online trends develop from a few users to a large following.
“The same can be applied to clothes. They see people wearing Jordans, they’re going to want to buy Jordans,” he added.
Toxic tactics
Christian Payumo and Dezirie Peñaflor of the Philippine Smoke-Free Movement (PSFM) pointed to marketing tactics and flashy advertisements as causes of the “vaping epidemic.”
PSFM is an advocacy group focused on promoting smoke-free environments. They have been active in lobbying for policies such as the Sin Tax Reform Law and the Republic Act No. 11467, which increased the taxes on tobacco, alcohol and nicotine products to discourage consumption and fund public health programs.
Payumo pointed out the onslaught of online influencers donning shirts with vape brands, decorated lanyards and events sponsored by vape companies. He called it “subtle marketing.” For them, these tactics fog the actual risks of vaping.
The flavors are specifically designed to attract young people, normalizing the product and reversing the idea that it is “toxic.” With enticing aromas, eye-catching designs and a diverse array of flavors, vape aims to attract customers. Curious teens flock to it like moths to a flame.
Makati Medical Center cited a 2021 National Youth Tobacco Survey that revealed how approximately 85% of young e-cigarette users prefer flavored products, including options like fruit, candy, menthol and mint.
On top of this, purchasing devices have grown more accessible to young hands because of online listings.
Peñaflor drew attention to apps like Shopee, Lazada and TikTok shops. Although these platforms have protection features that will not show results containing the word “vape,” sellers try to bypass it.
“They’re using other codes like ‘battery,’ ‘flashlight,’ ‘adapter’ and others to still be able to sell online,” Peñaflor told The Flame.
There are also numerous claims circulating in social media that can exacerbate misinformation about vapes and their effects. Vape users tend to cling to the fact that vaping has fewer toxins than cigarettes, leading them to believe and spread the false claim that it is harmless.
“Parehong bisyo ang paninigarilyo at vaping. Hindi siya either-or (Cigarette smoking and vaping are both vices. It’s not an either-or situation),” Payumo said.
“We have to be careful na ‘di ibig-sabihin na bago lang ang vaping at konti lang ‘yung study, ‘di siya masama. Tuloy-tuloy ‘yung research about that and growing evidence na masama siya,’ he added.
(The fact that vaping is new or there are few studies about it does not mean that it is no longer harmful. It is continuously being researched, and there is growing evidence that it is harmful.)
Kicking the habit
James’ habit only lasted him about two months before getting caught vaping by a parent. Not long after that, his friends gradually stopped lending him their vapes.
With the fear of getting reprimanded once again, coupled with a lack of access to the product, James succeeded in quitting.
On the other end of the spectrum, long-time users like Simon admit they would have a difficult time letting go of this habit. Today, although he continues to manage his vape shop, he does not entice non-smokers and non-vapers to start the vice. Yet, he said that he remains sympathetic to those like him who have become reliant on vaping.
“I’ll quit vaping when I find an alternative coping mechanism or when all the problems of the world stop rushing in my life all at once,” he said.
“Vaping made everything easier for me. Take that away from me, and I might just start struggling.”
Medical experts and advocates, nonetheless, hammer on the importance of addressing this growing concern.
“There are more adolescents who vape than adolescents who smoke,” Payumo said. “That alone shows you the gravity of the problem.”
Yet letting go of such a habit begins with the willingness to do so, he said. Users may then seek guidance from smoking cessation clinics that offer counseling and medication.
The most common outlet is Quitline, launched by the DOH, which is a mobile-centered support service that, when called, offers guidance that can help smokers break free from their vices.
“In addition to the willingness of adolescents or people to quit vaping, the government or the state must provide proper services and a proper environment to encourage the youth to stop,” Payumo added.
“This is an effort that should be made by various stakeholders with the goal of reducing vaping among the youth.”
Despite the rise in vaping among the youth, Guillermo remains hopeful that such an issue could be resolved. She emphasized that this change thrives when society at large steps up: by strengthening health education to dispel myths and policies that prioritize well-being over profit.
“While there is still a lot to do, a multi-sectoral approach can be done to guide the next generation to make empowered, well-informed decisions,” the doctor said.
“I am truly hopeful that stricter regulations and increased health education initiatives would be prioritized in our country in the near future.” F
Editor’s note: The names of the two vape users, Simon and James, have been changed at their request to protect their identity and privacy.
