International:

A study about Knowledge and attitudes among medical students toward the
clinical usage of e-cigarettes which aims to assess knowledge and attitudes about
e-smoking among undergraduate medical students, specifically focused on favorable
view of therapeutic e-cigarette use for smoking cessation or harm reduction, about
399 students took part in total. Current smokers (19.8%) and former smokers (6.5%)
were included in the smoking history, whereas 36.6% of people used e-cigarettes and
11.5% are presently using them. Only 13.5% of respondents thought e-cigarettes were
FDA-approved for quitting smoking, whereas 31.1% and 31.1% of respondents,
respectively, said e-smoking reduced cancer risks and may aid in quitting smoking. In
addition, 35.9% agreed or strongly agreed that e-cigarettes are preferable to tobacco
products for patients, and 17.5% were inclined to suggest e-smoking to their patients
as a way to quit smoking. The six-item scale's reliability was indicated by Cronbach's
alpha of 0.676, which was raised to 0.746 following the addition of the question
concerning addictiveness. On the five-item adjusted scale, 23.6% of the participants
preferred the usage of e-cigarettes for therapeutic purposes. (Alzahrani, S. H. et.al.,
2021)

Alzahrani, S. H., Alghamdi, R. A., Almutairi, A. M., Alghamdi, A. A., Aljuhani, A.

A., & ALbalawi, A. H. (2021). Knowledge and attitudes among medical students
toward the clinical usage of e-cigarettes: a cross-sectional study in a university
hospital in Saudi Arabia. Risk Management and Healthcare Policy, 1969-1984.
Retrieved from: https://www.tandfonline.com/doi/full/10.2147/RMHP.S302309

According to Tehrani, H., Rajabi, A., Ghelichi- Ghojogh, M. et al (2022) in their

study, The prevalence of electronic cigarettes vaping globally that aims to determine
the national, regional, and global prevalence of electronic cigarettes (e-cigarettes)
vaping, vaping with e-cigarettes is now and historically prevalent at 23% (with a 95%
confidence range (CI) ranging from 21-25% and 11%, respectively). Women vaped
e-cigarettes at a lifetime prevalence of 16% and an actual prevalence of 8%,
respectively. Additionally, among men, e-cigarette use was currently and historically
prevalent at 22% and 12%, respectively. In this study, the lifetime prevalence of
e-cigarette use was 25%, 19%, 26% and 29%, respectively, among adolescents and
schoolchildren, adults, college students, and patients. Additionally, the current
prevalence of e-cigarette use was 11%, 14%, and 10%, respectively, in adults, college
students, and patients.

Tehrani, H., Rajabi, A., Ghelichi- Ghojogh, M. et al. The prevalence of electronic
cigarettes vaping globally: a systematic review and meta-analysis. Arch Public Health
80, 240 (2022). Retrieved from:
https://archpublichealth.biomedcentral.com/articles/10.1186/s13690-022-00998-w

In the study of Ruppel, T., Alexander, B., & Mayrovitz, H. N. (2021) entitled,
Assessing Vaping Views, Usage, and Vaping-Related Education Among Medical
Students: A Pilot Study, most of their responsdents were female and between the ages
of 18 and 25. Their study is sought to investigate the knowledge and perception of
vaping amongst future health care providers. According to them, nearly all of the kids
were aware of how vaping was bad for their health. More over two thirds of students
felt that their knowledge on vaping was insufficient, and the majority said that their
medical school curriculum had no influence on their opinions. Due to current news
and media, most students reported having a more unfavorable attitude on vaping.
More than two thirds of their the respondents indicated they had vaped at least once
and were referred to as "vapers." Half of vapers admitted to vaping within the last
year, and the majority of vapers did not believe their vaping had an influence on
others. The most prevalent reason for starting to vape was for recreational purposes.
Despite being aware of the risks, nearly one-third of vapers reported continuing to use
their devices, and others did not think that vaping was risky.

Ruppel, T., Alexander, B., & Mayrovitz, H. N. (2021). Assessing Vaping Views,
Usage, and Vaping-Related Education Among Medical Students: A Pilot Study.
Cureus, 13(2), e13614. Retrieved from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011463/

An article about boys who smoke and vape may have risk on passing the damaged
genes to their children stated that the researcher scientist looked at the fathers'
smoking habits of approximately 900 people between the ages of seven and 50. The
offspring of smokers under the age of 15 had 19 alterations across 14 genes linked to
asthma, obesity, and wheezing. The modifications discovered had an impact on how
cells controlled gene expression as well as how DNA was methylated and packed in
cells. The health of future generations will depend on the choices and actions made by
young people today, long before they become parents, especially for boys in early
puberty and mothers and grandmothers both before and during pregnancy, according
to Professor Cecilie Svanes of Norway's University of Bergen. Furthermore, early
puberty may represent a crucial window of physiological changes in males, according
to Dr. Negusse Kitaba, a research fellow at the University of Southampton. The stem
cells that will produce sperm for the rest of their lives are developing at this time.
(Independent, 2023).

Independent. 2023. Boys who smoke and vape ‘risk passing on damaged genes to
their children’. Retrieved from:
https://www.independent.co.uk/news/health/vaping-smoking-health-impact-teenagers
-b2401840.html

According to BMJ (2022), a major shift in nicotine intake is anticipated as a result of

the widespread adoption of vaping. Over the past ten years, vaping has become more
and more popular, helped in part by advancements in nicotine flavour and vape pen
design. The usage of vape pens, which have replaced traditional cigarettes as the
primary method of nicotine ingestion, has increased most among teenagers and young
people. The possible effects of prolonged vaping on the pulmonary system, however,
are largely unknown. The use of vaping as an aid for quitting smoking and reducing
the damage from tobacco use is still debatable. The 2019 EVALI (E-cigarette or
Vaping usage-Associated Lung Injury) epidemic brought attention to the risks
associated with vaping, although the effects of long-term usage are yet unclear. Here,
we examine the expanding corpus of research examining how vaping affects
respiratory health. We examine the clinical signs of vaping-related lung damage, such
as the EVALI outbreak, as well as the results of covid-19 and the impact of persistent
vaping on respiratory health. We come to the conclusion that vaping has certain risks
and that further research is needed in order to develop clear public policy guidelines
and regulations.

BMJ. 2022. Impact of vaping on respiratory health. Retrieved from:

https://www.bmj.com/content/378/bmj-2021-065997

Local:

According to Baclig, E.C, a reseacher/writer from INQUIRER. NET (2023), To

protect future generations and all Filipinos from tobacco-related illnesses and deaths,
plain and standardized packaging is necessary, according to a study that examined
young adults' perceptions of various cigarette packaging designs. According to the
2021 Global Adult Tobacco Survey, 14.4 million adults in the Philippines, or roughly
18.5 percent of the adult population, smoke tobacco. The number of adults that smoke
tobacco everyday in the nation is at least 11.2 million. Given the packaging designs,
the researchers emphasized that flavored cigarettes could be influencing young
persons' decision to start smoking. The study's results, they said, suggest the use of
simple and uniform packaging, a prohibition on product displays at points of sale, and
restrictions on flavored tobacco, including flavor capsules and other filter
advancements. According to data from the Philippine Pediatric Society, 11% of
students between the ages of 10 and 15 had previously tried vaping. According to the
Department of Education, 6.7% of students in Grades 7 to 9 have tried and are using
e-cigarettes. The most common justifications for vaping among students were online
accessibility, which accounted for 32% of use, as well as a variety of flavors and the
idea that e-cigarettes are less harmful than tobacco, which accounted for 22% of use.

Baclig, E.C. 2023. Tobacco packaging: Getting PH youth hooked on smoking, vaping.
Retrieved from:
https://newsinfo.inquirer.net/1824163/tobacco-packaging-getting-ph-youth-hooked-on
-smoking-vaping

In one article entitled 'Vaping ineffective vs smoking' wrote by Mondares, C.B.

(2023), a specialist warned on Tuesday that switching from regular cigarettes to
electronic smoking devices does not help smokers completely give up the habit.
According to her, 4.1% of people aged 13 to 15 who participated in the Global Youth
Tobacco Survey in 2021 reported using vape. Although tobacco corporations
advertise "smoke-free" cigarettes, according to Limpin, using vape and e-cigarettes is
just as risky as smoking since they still contain nicotine and other carcinogens. The
majority of persons who use ENDS or ENNDS do not quit smoking cigarettes but
instead wind up using both products, according to Limpin, who highlighted research
from the United States in 2018, Australia in 2019, and the United Kingdom in 2015
where nicotine was found in some samples of e-cigarettes marketed as "nicotine-free."
Furthermore, statistics revealed a relative drop in cigarette usage between 2009 and
2021, thanks to the work of the health sector and other important partners. According
to the Global Adult Tobacco Survey, there will be 14.4 million fewer adult smokers in
2021 than there were in 2009 which is about 17.3 million. According to Limpin, the
dangers of smoking to health must continue to be highlighted and not withstanding
the drop in tobacco usage.

Mondares, C.B. 2023. 'Vaping ineffective vs smoking'. Retrieved from:

https://www.manilatimes.net/2023/08/30/news/national/vaping-ineffective-vs-smokin
g/1907667

An article entitled, Vaping and the youth: Experts raise alarm on health risks,
wrote by Villanueva R. (2023) stated that, a nonprofit that focuses on children's health
has issued a warning about potential ailments that kids across the nation might
contract as a result of vaping. Teenagers and even younger people are increasingly
readily seduced into vaping, according to Dr. Rizalina Gonzalez of the Philippine
Pediatric Society (PPS), making them more susceptible to various ailments.
According to her, teenagers first started using mod- or tank-based vapes in 2017 and
noted that although vaping can create clouds and tricks, the majority of the children
who use it have tonsillar abscesses. Gonzalez stated that around 14.1% of school-aged
adolescents currently smoke electronic cigarettes or vapes, citing the 2019 Global
Youth Tobacco Survey (GYTS) that was published in 2021. The prevalence of
e-cigarette users among adolescents, defined as those 15 years of age and under, has
significantly increased which previously stood at 11%. before. According to the
Philippines leads the list of Southeast Asian nations where teen vaping is on the
increase, Gonzalez said, that the survey was based on school children, therefore, the
figures may be higher if we include the out-of-school youth. Researchers from the
organization Action on Smoking and Health (ASH) Philippines found that the usage
of e-cigarettes has increased dramatically worldwide since they were introduced to the
market in 2004.

Villanueva R. 2023. Vaping and the youth: Experts raise alarm on health risks.
Retrieved from:
https://www.philstar.com/headlines/2023/06/30/2277546/vaping-and-youth-experts-ra
ise-alarm-health-risks-