Rafael Castillo is a Professor in Cardiovascular Medicine at the College of Medicine in the Adventist University of the Philippines. He also works as a Senior Consultant in Adult Cardiology at the Manila Doctors’ Hospital, and is the Dean Emeritus and Head of Cardio-Metabolic Research Unit.
As a cardiology expert, Castillo is ideally placed to comment with authority on vaping and its potential to offer harm reduction to current smokers - comment that is needed given the questions being asked by some sceptical members of the Pinoy medical community.
Speaking about the stop smoking clinic he is involved with, he said: “we used to have a condemning, somewhat discriminatory attitude toward our recalcitrant smokers. We gave them six months to quit smoking completely, either cold turkey or through other known interventions. But if they failed, they’re politely told to go to other clinics. They’re no longer given appointments for follow-up.”
It's a story similar to that experienced by many around the world, except now Rafael Castillo believes “we would like to put our smokers back into the health equation.”
The catalyst for Castillo’s change of heart came from the Covid-19 pandemic. Acknowledging that smoking plays a key role in developing severe symptoms, “it always broke our hearts to hear of a former patient whom we’ve ‘expelled’ from the clinic being hospitalised for severe COVID-19 or succumbing to it.”
While he doesn’t know for certain if helping those smokers to switch to vaping would have helped them experience milder symptoms or not die, he states e-cig vapour contains “far less [SIC] toxic substances compared to burnt cigarettes”.
Incredibly, in a statement not heard from anti-vaping clinicians in Australia, Canada, and the United States, he adds: “Our support for the vape bill is probably partly the product of a guilty conscience and an effort to do penance for the medical injustice we have committed against our recalcitrant smokers. We unjustly excluded them from the health equation previously, as if their lives didn’t matter, and they deserved whatever complications they were likely to develop with continuous smoking.
“But we now realise that smokers who may have tried to quit a hundred times and failed — just like in Mark Twain’s quote (‘Giving up smoking is easy; I’ve tried it a thousand times’) — remain part of the health equation as much as the healthy non-smokers, the youth and others we’re trying to protect from this killer vice.”
Academics and public health campaigners around the world who continue to oppose the use of electronic cigarettes ought to pay heed to Dr Rafael Castillo’s change of heart, and maybe consider another Mark Twain quotation: “It is wiser to find out than to suppose.”