Smokers told how to cut oral cancer risks

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    A RESPECTED Filipino dental expert is urging smokers unable to quit to switch to smoke-free alternatives such as e-cigarettes and heated tobacco products.

    “We warn our patients who are smokers that smoking is the leading cause of oral cancer and strongly advise them to quit smoking. For those who cannot or do not want to quit smoking by themselves or with currently-approved methods, we convince them to switch to non-combustible alternatives,” Dr. Fernando M. Fernandez, president of the Philippine College of Oral and Maxillofacial Surgeons and past president of the Philippine Dental Association, said.

    While clarifying that he does not endorse any particular brand or product, Fernandez, spoke during the “Scientific Conversations on Tobacco Harm Reduction” recently at the Shangri-La at the Fort in Taguig City. The event was organized by human data science company IQVIA to provide a platform for Filipino healthcare professionals to have a scientific and evidence-based discussion regarding concerns on e-cigarettes and heated tobacco products (HTPs).

    “When a smoker lights up a cigarette, the burning or combustion of dried tobacco leaf at high temperature produces cancer-causing toxins that are subsequently inhaled by the smoker,” Fernandez explained.

    He cited the Public Health England independent evidence review and the UK Parliament Science and Technology Committee report. Both concluded that e-cigarettes are at least 95 percent less harmful than combustible cigarettes. Without combustion, there’s no tar and carbon monoxide, which are the most dangerous components of conventional cigarettes.

    Fernandez quoted the Public Health England statement describing e-cigarettes as “an opportunity to significantly accelerate already declining smoking rates in the UK, and thereby tackle one of the largest causes of death in the UK today.”

    Unlike conventional cigarettes, e-cigarettes heat and vaporize liquid at lower temperatures and do not burn organic matter. Therefore, e-cigarettes do not emit toxicants produced by the process of burning or combustions. The main components of the liquid used in e-cigarettes (“e-liquid”) are propylene glycol and glycerin. The remaining components are water, nicotine, and flavorings.

    HTPs heat tobacco just enough to release a flavorful nicotine-containing vapor without burning the leaves. Because the tobacco is not burned, the levels of harmful chemicals produced by HTPs are significantly lower compared to combustible cigarette smoke. A popular HTP brand is IQOS, an electronic device that heats tobacco-filled sticks wrapped in paper, called HEETS or HeatSticks, to generate a nicotine-containing aerosol.

    Fernandez believes tobacco harm reduction measures such as e-cigarettes and HTPs can help prevent oral cancer, and is a better strategy “than watching our patients who smoke die of oral cancer.”

    Oral cancer is the 11th most common form of cancer in the country, according to the 2015 Philippine Cancer Facts and Estimates published by the Philippine Cancer Society and Department of Health.

    Fernandez stressed that “early diagnosis is the single most important factor in successfully combating oral cancer” and dentists have a crucial role in the early identification of its possible warning signs.

    “One of the advocacies of PCOMS is to promote awareness on oral cancer among Filipino dentists. The dentist is the first line of defense against oral cancer. He or she will almost always be the first healthcare professional to notice potentially cancerous lesions in the patient’s mouth and other early symptoms of oral cancer,” he noted.