E-cigarettes are seized by the Hà Nội's Market Mangement Department. — VNA/VNS Photo

HÀ NỘI — Although positive progress has been made in reducing smoking rates and exposure to second-hand smoke, the emergence of e-cigarettes, heated tobacco and new ways of bringing these products back onto the market is creating an urgent need to further reform and strengthen policies, improve enforcement and better protect public health.

The 2021 STEPS survey said the smoking rate among adults in Việt Nam stood at 20.8 per cent, equivalent to around 15.8 million smokers.

The rate among men was as high as 41.1 per cent, compared with just 0.6 per cent among women.

Compared with 2010, the adult smoking rate fell from 23.8 per cent to 20.8 per cent in 2021.

However, the decline of only around three percentage points over more than a decade shows that progress remains slow and falls short of expectations.

Việt Nam is still among the 15 countries with the highest rate of smoking among adult men worldwide and ranks third in ASEAN.

This remains a major challenge to efforts to reduce tobacco use and control health risk factors among the population.

Among adolescents, the smoking rate has also declined, from 5.36 per cent in 2013 to 2.78 per cent in 2019 among those aged 13-17.

However, these gains are at risk of being undermined by the emergence and growing availability of new tobacco products, particularly e-cigarettes and heated tobacco.

Access to new nicotine-containing products could lead to the emergence of a new generation of nicotine users, while undermining the progress made in tobacco harm prevention and control in recent years.

Over 100,000 deaths annually

Tobacco is a major cause of many chronic and non-communicable diseases and one of the leading causes of death, even though most of these health impacts are entirely preventable.

According to estimates from the Global Burden of Disease study cited by the World Health Organization (WHO), tobacco use causes more than 100,000 deaths in Việt Nam each year.

Of these, around 84,500 deaths are attributable to active smoking and 18,800 to exposure to second-hand smoke.

Alongside the health impacts, tobacco also places a significant economic burden on society.

Total healthcare costs attributable to tobacco-related diseases were estimated at around VNĐ92.4 trillion (US$3.61 billion) in 2019, rising to VNĐ108.7 trillion ($4.25 billion) in 2022. Losses resulting from premature deaths accounted for about 79 per cent of the total economic burden.

Spending from the Health Insurance Fund on medical examinations and treatment attributable to tobacco use was also substantial, reaching around VNĐ8.3 trillion ($342.2 million) in 2019 and VNĐ8.7 trillion ($339.8 million) in 2022, equivalent to approximately 7.5 per cent of total spending from the fund.

Overall, the economic burden of tobacco-related health impacts was estimated at the equivalent of 1.14 per cent of GDP in 2022.

New challenge emerges

Authorities have detected and seized components, devices and e-liquids used to assemble e-cigarettes. However, controlling individual components remains challenging.

If regulations focus only on finished products, manufacturers and traders could exploit loopholes by importing or distributing components and materials used to assemble banned products.

A draft law amending the Law on Prevention and Control of Tobacco Harms proposes prohibiting the production, trading, storage, transportation, import, export, transit and use of e-cigarettes, heated tobacco products and other tobacco items.

It also proposes banning the production, purchase and sale, import and export of electronic devices, components and liquids used to assemble or produce such products, except in cases permitted under the Law on Investment.

Hà Anh Đức, Director of the Department of Medical Examination and Treatment under the Ministry of Health, said the draft also expands the legal definition of 'tobacco' to cover e-cigarettes, heated tobacco products and other nicotine-containing devices.

It introduces definitions of e-cigarettes, heated tobacco products, electronic devices, specially manufactured tobacco products and other tobacco products, providing a clearer legal basis for enforcement.

Policies need strengthened

One important practical basis for further improving the legal framework is the change in poisoning cases and violations involving e-cigarettes and heated tobacco products following the entry into force of Resolution No. 173/2024/QH15.

Preliminary data from the Poison Control Centre at Bạch Mai Hospital show that, following the ban, the number of emergency cases related to e-cigarettes and heated tobacco products fell significantly.

Before the ban, over a 22-month period, the centre received 120 emergency cases linked to the use of e-cigarettes or heated tobacco products, averaging five to six cases a month.

Some patients suffered severe brain damage after using e-cigarettes.

Since the ban was adopted, the centre has treated only one or two emergency cases involving e-cigarettes and heated tobacco products each month.

Public advertising of these products by influencers and their open sale in shops have also fallen sharply, almost disappearing after enforcement agencies stepped up inspections and sanctions.

Data from the Ministry of Public Security further indicate a notable change. Before Resolution No. 173/2024/QH15 took effect, from 2020 to the first quarter of 2024, police nationwide detected and dealt with 728 cases involving 883 people in connection with e-cigarettes and heated tobacco products. — VNS