Taiwan looks set to become the next country in Asia to ban nicotine vaping products.
On January 12, amendments to the Tobacco Hazards Prevention Act effectively cleared the legislative floor. Now, the legislation only awaits a presidential nod—a formality given that President Tsai Ing-wen is from the ruling Democratic Progressive Party that proposed it.
The news, which arrives not long after the Philippines enacted relatively pro-vape regulations, has elicited strong reactions from consumers, policy experts and medical experts, who had some hopes that the tide might be turning in favor of tobacco harm reduction (THR).
Taiwan appears to be emulating regulations in nearby Japan, where heated tobacco products (HTPs) are sold legally but nicotine vapes are prohibited. The availability of HTPs in Japan has seen a dramatic reduction in cigarette sales. But THR advocates will wonder why an option indicated to have an even lower risk profile—and shown to be a more effective smoking cessation aid than nicotine replacement therapy—is about to become formally illegal. Other Asian countries to have banned vapes include India and Thailand.
The imminent ban includes use of e-cigarettes, with penalties of up to $330 for violations.
In Taiwan’s strained governmental nomenclature, HTPs have been classified “designated tobacco products” and are subject to regulation, while vaping devices have been accorded the category of “tobacco-like products.” The imminent ban includes use of e-cigarettes, with penalties of up to $330 for violations. (Previously, vapes had existed in something of a legal gray area.)
This has ignited debate in Taiwan, a country of 24 million where 13 percent of the population smokes, including almost a quarter of men. While millions of upset vape users have been left in the lurch, anti-tobacco groups are meanwhile demanding HTPs be banned too. The law, which will likely come into effect in a month after the presidential assent, will inevitably force vape shops to close and a rapidly growing industry to shutter or go underground.
While it’s difficult to deduce the motivations for the legislative decision, Taiwan policy experts and vape users point to a combination of misinformation, financial considerations trumping public health, and the positions taken by World Health Organization’s Framework Convention for Tobacco Control (WHO FCTC) on novel nicotine alternatives.
“The issue did not have enough public discussion and the approach to harm reduction should be more thoroughly debated,” Simon Lee, the Taiwan policy fellow at Consumer Choice Center, a global consumer advocacy group in Washington, told Filter. “For instance, we have seen misinformation, especially with regard to nicotine, circulating among anti-tobacco activists. It is beyond reasonable doubt that Taiwan’s consumers deserve a much better outcome.”
Taiwan’s willingness to comply with WHO positions could be seen as a way to create pressure for its membership in the future.
Even though Taiwan has been repeatedly denied membership of the WHO, the rationales provided in the bill rely heavily on the agency’s positions. For heated tobacco, the bill refers to WHO’s 2020 statement that HTPs are tobacco products and FCTC guidelines should be fully applied to them. In the case of vaping products, references are made to FCTC recommendations in its conventions six and seven (held in 2014 and 2016) that nations should “prohibit or regulate them.” Taiwan’s willingness to comply with WHO positions could be seen as a way to create pressure for its membership in the future.
“We can certainly see the Taiwan government’s wish to play a much bigger role in global public health policymaking,” Lee said. “However, we have to point out that blind adherence to WHO and its subordinate institutions is not the way to go. It is clear that WHO acted unaccountably on many issues, including that of Taiwan’s membership. During the Wuhan pneumonia outbreak, the Taiwan government showed it can lead the global public health debate. It is now time for Taiwan to show the world what the best practices are, including that on harm reduction.”
Danny (Yu-Yang) Wang, who leads VAPE Taiwan, a tobacco harm reduction media and advocacy organization he founded in Taiwan’s capital of Taipei in 2017, told Filter that the government has listed many reasons for the ban—alleging that vaping is bad for health, causes “EVALI,” includes cannabis use, has “gateway” potential, leads to a youth epidemic, and so forth. Legislators have publicly reasoned that e-cigarettes are “complicated chemical products and hard to regulate, so it is better to ban them,” Wang said. But the fight for control over nicotine between the pharmaceutical and tobacco industries might, he continued, be at the heart of it.
“Tobacco is controlled by the tobacco companies while nicotine is in the domain of the pharmaceutical industry,” Wang said. “While the former got their way with HTPs, vaping products were banned because Big Pharma would not let go of its monopoly over nicotine.” He added that meanwhile, for HTPs, variants that have passed the US FDA pre-market authorization process will be allowed. “It is like Taiwan is the 51st state of America.”
“To trade the health of the people for money just isn’t right.”
“Banning a substance has never worked, especially an addictive one,” said a medical professional who spoke to Filter on condition of anonymity, fearing retribution for speaking against government policies. “We know that the taxes from tobacco, which amount to the range of billions to tens of billions, are used on several government policies and to fund agencies, and have quite an impact on the government’s finances. But to trade the health of the people for money just isn’t right.”
Suggesting that the inevitable outcome of this ban will be an illegal market, he said, “Given the history of government ineffective enforcement on tobacco products, one can easily spot underage smoking everywhere. Vaping will be left with no other option than going underground.”
Vape users in Taiwan interviewed by Filter echoed this sentiment, along with resentment over the policy decision. “Politicians who voted for the ban should be held accountable,” Robin W.*, a 56-year-old Canadian living since 2000 in Taichung, a city in central Taiwan, told Filter. “Legislative voting here stems from an old system such that no individuals in the government can be held responsible. The people need to demand the names of those who voted for the vape ban. If something like that were to happen, I believe many of the politicians who are hiding under this archaic cloak would change their vote.”
Robin, who switched from smoking to vaping eight years ago after a health scare and has seen improvement since, said the ban is unlikely to deter vape users, though it could discourage people who currently smoke from making the switch. “It is going to be a lot more difficult to find supplies,” he said. “For those who can, I don’t think things will change much. There are so many laws here that aren’t enforced and police officers don’t care much about smaller fines. Of course, vapers will tend to be more careful about vaping in public. And there will be a general feeling of being ostracized by society more so than even now.”
“I am already getting links to continue vaping after the ban.”
There is so far little indication of organized consumer pushback against the ban, even if some hope the president will seek a rewrite of the bill. But Wang said about 3 million people have tried vaping or HTPs in Taiwan—a significant voting bloc that the government cannot afford to antagonize, especially ahead of the general elections due next year. “For this reason, I have initiated an email campaign for the Taiwanese to write to the president seeking review of the bill,” he said.
Meanwhile, despite heavy fines of up to $329,000 for selling, many vape vendors are gearing up to make a transition to the underground economy. “Prices will most likely go up, but not by as much as one might expect,” Robin said. “The stores sell their products at much higher rates than you can find on the internet, so people are used to that. I am already getting links to continue vaping after the ban.”
* Name abbreviated to protect privacy at source’s request.
Correction, January 24: This article has been edited to correctly represent Wang’s estimate of THR uptake. An earlier version wrongly characterized it as 3 million people having switched from cigarettes to vapes.
Photograph of Taipei by 毛貓大少爺 via Flickr/Creative Commons 2.0