By Lina Sagaral Reyes, Special Correspondent .
DYING young due to the novel coronavirus hovered close to mind as Lavender Angilee (not her real name) decided to quit vaping cold turkey in March last year, barely a week after President Rodrigo Duterte declared a nationwide community quarantine to stave off the spread of the epidemic.
It helped her that all vape shops in town closed down and daily press briefings spearheaded by the city local government emphasized that smoking cigarettes and vaping could place even young adults like her at-risk.
By the time the World Health Organization (WHO) had issued a statement in April on the Covid-related hazards of smoking and vaping, she had offered her two vape mods and dozens of juice vials for sale in a Facebook vapers group, and in two hours these were sold at giveaway prices. She noticed that many others were also selling their vaping kits, though there are still many persisters, who urged her to wait till the pandemic was over. She used the proceeds from the impulsive sales to buy face masks and disinfectants for her family.
Lavender Angilee, 24, is a contract worker at a third-party service provider for a telecommunications company who learned to smoke cigarettes late in college, having been initiated into it by her first romantic partner.
Smoking menthol cigarettes for the duo was a weekend after-school de-stressing ritual, she recalled.. They could not smoke in school since student guidelines at the private Christian college where they studied explicitly prohibited smoking and vaping. Stiffer penalties including expulsion were imposed on offenders. At home, smoking was tolerated as everyone, both her parents and two brothers, smoked cigarettes.But when her girlfriend ditched her for an older man a year ago, she switched to e-cigarettes.
“I learned to hate the smell of mentholated cigarettes as it reminded me of her,’’ she recalled. She explored vaping by chance. Her father wanted to stop smoking as his diabetes mellitus had worsened, and his doctor advised a slow weaning via vaping. Lavender Angilee became her father’s errand girl to a vape shop.
Switching to vaping from cigarette smoking however is not considered within the Philippine medical community as a sound strategy for smokers who want to quit.
Michael Blaha of John Hopkins Ciccarone Center for the Prevention of Heart Disease, that although the vaping industry has been aggressively marketing vape as an alternative to smoking cigarette and/or as a tobacco cessation tool, the Food and Drug Administration in the US has not approved it as a smoking cessation device. A recent study, according to John Hopkins, has showed most people who intended to use e-cigarettes to kick the nicotine habit ended up continuing to consume both traditional and e-cigarettes.
Vape and the LGBTs
But for Lavender Angilee, she said her first and last goodbye to cigarettes and embraced vape. It was not difficult to get hooked, she recalled. Her choice flavor became cookies and crème, which reminds of her childhood’s savory ice cream. She steered away from the fruity flavors like strawberry and lemon since it reminded her again of her girlfriend’s perfumes. She was also convinced that e-cigs,as the vape advertisements said, were far more less damaging to her lungs than cigarettes.
A US-based study in 2019 showed that those who like Lavender Angilee identify themselves with the Lesbian, Gay, Bisexual, and Transgender (LGBT) have a high rate of e-cigarette use. The Baylor College of Medicine study, which said that 4 out of 10 LGBT individuals use e-cigarettes, is based on the 2016 and 2017 Behavioral Risk Factor Surveillance Survey of the Centers for Disease Control. About 38 percent of the LGBT respondents said they’d vaped as compared to 20 percent for straight adults.
Public health experts had suggested that interventions like messaging on vape harms must focus on this segment of communities.
Vape marketeers target this particular segment in the population.
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Meanwhile young adults and teens like Lavender Angilee are also the main targets of the e-cigarette marketing as evidenced by its youth-oriented themes, its array of nostalgic flavors, and the use of social media platforms, observed by Southeast Asia Tobacco Control Alliance (SEATCA) in its recent report, ‘’Today’s Teens, Tomorrow’s Customers: baiting youth with new tobacco products to make a new generation of addicts.’’ The report was launched amid the Covid pandemic on May 31, 2020, World No Tobacco Day.
Meanwhile, Lavender Angiilee and her father stuck to their abstinence through weeks of lockdown as both of them gained weight despite a daily exercise regimen. It helped that she began to work from home. This, even as her brothers and mother also curbed their cigarette smoking.
By May, they both considered vaping again as the community quarantine rules were eased to modified general quarantine and vape shops, taking cue from restaurants and supermarkets, offered drop-by take-outs and even delivery services to customers.
Fortunately, Lavender Angilee managed to continue her abstinence as her dad took the more drastic path of seeking online behavioral counselling with a psychiatrist who prescribed nicotine patches.
The World Health Organization (WHO) by this time in May had issued a statement saying, “there is no evidence about the relationship between e-cigarette use and Covid-19. However, existing evidence indicates that electronic nicotine delivery systems (ENDS) and electronic non-nicotine delivery systems (ENNDS), more commonly referred to as e-cigarettes, are harmful and increase the risk of heart disease and lung disorders. Given that the Covid-19 virus affects the respiratory tract, the hand-to-mouth action of e-cigarette use may increase the risk of infection.’’
Within a week, Angilee’s craving was perked by a controversial item on her Facebook newsfeed saying that nicotine might aid in fighting against the Sars-Cov-2, the virus that causes Covid-19.
But soon after, it was doused by another WHO statement saying that:’’ There is currently insufficient information to confirm any link between tobacco or nicotine in the prevention or treatment of Covid-19.’’ The WHO further urged researchers, scientists, and the media to be cautious about amplifying unproven claims that tobacco or nicotine could reduce the risk of Covid-19.‘’
Need for vaping regulation
In Cagayan de Oro, vaping remains hardly regulated, making it easier for young vapers like Angielee to access e-cigarette kits from about 15 vape shops around the city and nearby suburban villages. The only constant is that the shops must stay a hundred meters away from the perimeter of schools , university campuses, and other learning centers.
Earlier in 2017, Kagawad Ruben Daba had proposed a comprehensive anti-vaping ordinance prohibiting the use, sale, distribution, and advertisement of electronic cigarettes in public places. The ordinance was discussed on the committee level and was also discussed in 2019.
Dr. Maria Lourdes Gaane, chair of the committee on health and health insurance of the city council, said the ordinance, is still on the table.
Daba said he intends to bring the ordinance to the council but Gaane as committee chair holds the ball. Gaane, however, has not replied to our requests for interview and/or comment on the ordinance.
While the panel at the daily city press briefings would now and then discuss the ill-effects of smoking and the imperative to quit in the past nine months of quarantine, these admonitions remains mere rhetorical as no policy had been drawn yet to buttress support to both youth and adults who would opt to quit smoking and vaping in the midst of the pandemic.
Early on, Mayor Oscar Moreno had issued an executive order banning the drinking of alcoholic drinks in public places but he issued nothing on cigarette smoking nor on vaping though a circa 1980s ordinance prohibits smoking in public places and a local Task Force had been constituted soon after President Duterte issued an executive order on a smoke-free environment in 2017. But daily police reports of apprehensions at the briefings do not include any breaches of this no-smoking ordinance.
The city epidemiologist in December 2020 also revealed that the screening questionnaire for Covid-suspects and Covid-positives excludes their smoking and/or vaping history.
According to Dr. Lorraine Nery, city health office in-charge, each barangay health center has a tobacco cessation desk, part of the health department’s nationwide tobacco cessation program.
‘’(But) It is face-to-face and based at the local barangay health centers which many avoid for fear of coronavirus infection,’’ Angilee pointed out as she precludes any visit to the center herself.
Covid-19 and Young Vapers
Dr. Bee-jay Rocha of the Northern Mindanao Medical Center addressed the youth who he thought find vaping ‘cool’: “I tell you straightforward: there is nothing cool when you get intubated. We will tell them, tell you when you become our patient, nothing ‘chuy’ (local streetsmart term for ‘cool’) about the detrimental effects, when your body is betrayed by your vice, when I will have to perform a bypass operation, there is nothing cool at all in these,’’ the cardiologist and surgeon said.
As WHO noted the rise of Covid-19 infection among young people worldwide, two major researches published in the Journal for Adolescent Health established direct links between vaping among the youth and Covid-19 infection.
In July 2020, a study by the University of California, San Francisco (UCSF) said that a third of USA’s youth may be at risk of getting seriously sick with Covid-19, especially if they smoke or vape.
It concluded that smoking or vaping was the most common risk factor for severe Covid-19 complications among healthy young people in the survey.
It also noted that gender-wise, young men, smoking or vaping, may more than double the potential of being hospitalized, needing intensive care, or even dying from the virus. For young women, who suffer more from other risk factors like obesity and immune conditions, smoking or vaping could increase the possibility 1½ times.
The authors looked for Covid-19 risk factors, like coronary diseases, diabetes, asthma, immune conditions, liver conditions, obesity and smoking. The study authors added e-cigarettes to tobacco and cigars because previous research showed they cause similar lung damage.
Another study released in August 2020 by scientists at the Stanford University School of Medicine zeroed in on young vapers between the age of 13 and 24 who were Covid-positive in May 2020 and concluded that young people, including teens, who vaped, are five to seven times more likely to get infected with Covid-19.
“Teens and young adults need to know that if you use e-cigarettes, you are likely at immediate risk of damaging your lungs,’’ Bonnie Halpern-Fisher, the study’s senior author, was quoted in a press release.
The Stanford University research did not explain why vaping increases a young person’s chance of getting sick, but it noted that vaping affects the lungs or immune system and that vapers tend to share devices and touch their faces more as they puff.
Mental Health and Vaping
Recognizing that substance abuse like nicotine addiction is a mental health issue, Dr. Nery said that would-be quitters can also seek psycho-social counselling from telehealth numbers of the city health office, the city government hospital as well as at the regional hospital and the Department of Health phone-in help centers.
‘’Drop it decisively, do not wait till you get ill,’’ she urged even as she mentioned the ‘sangkatutak’ (myriad) public health strategies, including scare tactics, employed by government to persuade people to stop smoking and vaping.
For Angilee, access to data like these motivated her to resist her own cravings, the high anxiety, and the extreme temptation to go out and buy a new vape kit again. To counter her thoughts she considers negative, instead, she shed membership in social media vape groups and unfollowed the social media pages of vape shops.
Everyday balancing acts like LavenderAngilee’s is part of adapting to the New Normal, says psycho-therapist Anna Katrina Oaminal-Watin.
“The (pandemic) crisis is now embedded in our daily lives especially because of the length of time it is happening. We need to accept that we are into the New Normal phase. We have to adapt. We have to discern the things we are in control of and things which are beyond our control, and stay focused on those thoughts from which spring our action.’’
Lavender Angilee hopes keeping away from vaping is among those aspects of her life within her wilful control towards the post-pandemic Brave New Normal.
As the days segued into a new year, she joined an LGBT support group among her colleagues at work that champions LGBT rights and also confronts health issues like tobacco addiction and drug abuse.
‘’I realized that I may not be able to sustain abstinence on my own. I have to connect with others who are like-minded and believe in good health as important in having a quality of life even after the pandemic is over,’’ she said.
(This story was produced under the “Nagbabagang Kuwento Media Fellowship Program Cycle 4’’ by Probe Media Foundation Inc (PMFI) and Campaign for Tobacco-Free Kids (CTFK). The views and opinions expressed in this piece are not necessarily those of PMFI, CTFK nor of this publication.)
