What It’s Like to Be a Tobacco Harm Reduction Advocate in Taiwan

    Vaping captures headlines in the United States, where outcry over a perceived youth “epidemic” drives health misinformation and efforts to restrict products that could save smokers’ lives—with international implications.

    But tobacco harm reduction’s most important battleground, where more than half of the world’s smokers live, is Asia. The continent is home to a diverse range of nicotine policies, ranging from innovative approaches that the world should watch to harsh prohibitions.

    Taiwan has chosen the latter path. Nicotine vapes are broadly banned in the country of 24 million off the coast of mainland China—although there are legal complexities and gray areas, with one lawsuit by vape sellers succeeding against the government and legislative amendments pending.

    Last year, smoking among Taiwanese youth reportedly increased for the first time in a decade. Vaping, despite the restrictions, rose even faster, however—and was duly described as a “stepping stone” to smoking by government sources. It’s tempting to wonder whether youth smoking would have increased in an environment where vapes were unequivocally more readily available than cigarettes.

    Danny (Yu-Yang) Wang is a human rights activist who leads VAPE Taiwan—a tobacco harm reduction media and advocacy organization that he founded in Taiwan’s capital of Taipei in 2017. Filter reached out to him to learn more about his work and the challenges that he and his allies face.

     

    Michael McGrady: What are the current laws in Taiwan governing e-cigarettes and other tobacco harm reduction products?

    Danny Wang: Electronic cigarettes are banned in accordance with Taiwan’s Tobacco Hazard Prevention and Control Law, the Pharmaceutical Affairs Law, and the Drug Control Regulations. [Large fines can apply to those who manufacture or import banned products.] The government’s position on heat-not-burn products is unknown and, as far as I can tell, there is no clear regulatory management method.

    Some legal loopholes allow the industry to exist here, however. For example, there’s the practice of selling nicotine-free products openly, while selling nicotine products under-the-table. And while Taiwan’s Tobacco Hazards Act specifically prohibits cylinder-shaped devices, it’s less clear when it comes to other shapes.

    Many products are smuggled into Taiwan. Some people here also manufacture vaping devices and e-liquids for export, using other names for their products, or claiming their e-liquids are nicotine-free. I’ve heard of vaping devices being exported as “heating devices.”  

     

    What is your background, Danny, and how did you become involved in tobacco harm reduction?

    I worked in health promotion in the past, mainly in the field of physical fitness. I was engaged by an international exhibition company from 2014 to about 2017. At that time, I became the first international vaping exhibition agent in Taiwan, selling overseas exhibition booths to vaping business owners here. That’s how I started contacting participants in Taiwan’s growing and dynamic vaping industry.

    I was personally able to switch from cigarettes to e-cigarettes. I then started participating in tobacco harm reduction advocacy. 

     

    What’s the current smoking rate in Taiwan? How embedded is smoking in Taiwanese culture, and which demographics smoke the most?

    According to our government’s data, the smoking rate in Taiwan in 2018 was 13 percent. It is much higher among men than among women. Data from the Ministry of Health and Welfare depicts smoking among men aged 36 to 40 years as high as 35.4 percent. You see smoking culture as a feature of business sales settings, for example.

    Data indicate that the rate of smoking among men with junior high educational levels is at 39.6 percent. But the real disparities in smoking in Taiwan occur among men without income. Their rate is 65.3 percent.

     

    How commonly do you think Taiwanese people understand the options that are out there for reducing the harms of tobacco?

    Rarely. The Taiwanese government and anti-tobacco groups still claim that harm reduction is the rhetoric of the tobacco industry, which is unbelievable.

     

    Have Taiwan’s media and government raised the alarm about youth vaping, as has happened in the US?

    Yes. The government, the media, anti-smoking groups, and opposing medical physicians continue to emphasize that taking up e-cigarettes will abduct young people to start smoking. [The city of] Taipei urged a clampdown on heated tobacco shops, too.

     

    What measures do you hope the Taiwanese government will take to reduce tobacco harms?

    It is hoped that the national government can accept the scientific evidence around tobacco harm reduction. This also includes [emulating] advanced national examples of tobacco control and tobacco harm reduction, with these strategies working hand-in-hand to achieve the goal of a smoke-free Taiwan by the year 2040. 

     

    How likely do you think it is that your government will do this?

    Frankly, I expect the difficulty to be extremely high. Funding for our health and welfare policies comes from the taxation of cigarettes. At least 70 percent of the funding for long-term public health care policy comes from the same funding.

     

    Can you describe your advocacy organization? Do you accept industry funding? 

    We established VAPE Taiwan Media in 2017, which is the only Mandarin media for the tobacco harm reduction “industry.” I am an independent advocate, because our government stops me from organizing an NGO, so I can only establish a media company—that’s why I call myself “for the industry.”

    As the leading Mandarin tobacco harm reduction media organization, VAPE Taiwan collects, analyzes, translates and disseminates the latest international industry news, research, and national data to help achieve the goal of a smoke-free Taiwan. Presently, we aren’t accepting industry sponsorships. 

     

    MM: How does your organization work with groups in other Asian countries to promote tobacco harm reduction? What is your international goal?

    The VAPE Taiwan system includes the Taiwan Tobacco Harm Reduction Association, the Foundation for a Smoke-Free Taiwan, and the Alliance of Banning Cigarettes Taiwan. We exchange information with other Asian tobacco harm reduction advocacy groups, mainly through Facebook, WhatsApp, Line, and other social networks. We are also currently affiliated with the International Network of Nicotine Consumer Organisations (INNCO) and the World Vapers’ Alliance (WVA). We hope to become a leading media outlet in the field of tobacco harm reduction for the Mandarin language and to bring forth awareness and factual information.

     


     

    Photograph of Danny Wang launching a legal challenge against Taiwan’s Ministry of Health and Welfare, courtesy of Wang/VAPE Taiwan

    Both INNCO and The Influence Foundation, which operates Filter, have received grants from the Foundation for a Smoke-Free World. Both The Influence Foundation and the author have received Tobacco Harm Reduction Scholarships from Knowledge-Action-Change.

    • Michael McGrady

      Michael is a journalist and researcher. His work has been supported by the Knowledge-Action-Change Tobacco Harm Reduction Scholarship program; the independently administered scholarship is supported by a grant from the Foundation for a Smoke-Free World. Michael is also the journalist-in-residence and visiting research fellow in tobacco and drug harm reduction policy at the American Consumer Institute, Center for Citizen Research. He conducts consumer-oriented and behavior research on the impacts of public health regulations on people who use drugs, especially nicotine. His work has appeared in the Wall Street Journal, the Hill and the South China Morning Post. He lives in Colorado.

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