Trisha, not her real name, said she started vaping when she was just 15 years old after a friend influenced her to try it. She was curious and thought the "first few puffs" would bring no harm.

"A friend of mine asked if I wanted to try to hit their vape. I said yes, then after that, I went inside the rabbit hole alone," she said.

Trisha, who vapes a few times a day, shared that she does it because it gives her a sense of relief.

Vaping is increasing among young people in the Philippines. In fact, it is the most commonly used tobacco product among Filipino youth.

In Manila's University Belt—home to some of the biggest private educational institutions in the country—students, regardless of age, can be seen using electronic cigarettes (e-cigarettes) and vapes.

But this is just the tip of the iceberg of another epidemic: The vape epidemic or the "vapedemic."

According to the 2023 National Youth Tobacco Survey, more than 2.1 million youth, or 7.7 percent of middle and high school students, currently use e-cigarettes.

Moreover, according to the World Health Organization (WHO), nine out of 10 started smoking e-cigarettes before they turned 18, attributing this to their affordability and the lack of health warnings.

Vaping is also often seen as a less expensive alternative to smoking. In the Philippines, the typical price of a vape device can range from approximately P400 to P800, depending on the type and features.

Entry-level disposable vapes are cheaper, while advanced mod kits can cost significantly more. A disposable vape offers around 600 puffs.

By contrast, a standard pack of cigarettes, which contains 20 cigarettes, costs nearly P200.

Dr. Maricar Limpin, former president of the Philippine College of Physicians, noted that more young people are being drawn to vaping because it is also marketed as a healthier alternative to smoking.

"If you look at the population that is using these products, we see that the majority of them are from the young ones, from the teens," she said during a health forum in Zambales last year.

Alarmingly, Limpin noted that 44 percent of vape users are non-smokers.

"It means that at an earlier time, they were already introduced to vape products," she added.

Dianne, also not her real name, said she vapes because it helps her relax and serves as a substitute for smoking

Dangers of vaping

In May 2024, the Department of Health confirmed the death of a 22-year-old Filipino male due to vaping. The Health department said the patient sustained a severe lung injury and was diagnosed with acute myocardial infarction or heart attack.

The patient was admitted to the hospital with severe chest pain, difficulty breathing. and experienced a heart attack caused by blockages in his two major arteries. Three days after admission, he passed away.

It was also found that the patient developed a serious lung condition known as e-cigarette or vaping-use-associated lung injury (EVALI). Further examinations showed severe pneumonia-like symptoms in the lungs, but no infections were detected—developed after two years of daily vaping.

Limpin said the patient "was not expected to develop lung and heart problems." She also cited one of her patients, a 16-year-old who developed acute lung injury from e-cigarette juice.

"Can we expect that there will be more young people who will acquire EVALIs? Yes. In fact, we are already seeing it," the health expert said.

"It's not just one patient. Unfortunately, we are now seeing more and more patients like this."

Philippine Heart Center Executive Director Dr. Avenilo Aventura warned that vaping is not a safe alternative.

He said e-cigarette users face higher risks of coronary artery disease, stroke, depression, and anxiety.

He also strongly warned that "there is no safe level of tobacco exposure," whether firsthand or secondhand, smoking can double the risk of heart attack and stroke by damaging blood vessels and increasing cholesterol buildup.

Health experts have also linked vaping to an increased risk of non-communicable diseases (NCDs), particularly respiratory and cardiovascular issues.

Moreover, vaping can cause lung damage, leading to conditions like lung injury, bronchiolitis, and even chronic lung disease.

Nicotine in vape products raises blood pressure and heart rate, leading to potential heart problems.

While Trisha admitted that she is aware that vaping has a lot of negative effects on one's body, she struggles to quit.

"I tried to quit vaping a lot of times already, but my body [has not] found its way to do so," she said.

"Pero recently, mas less yung pag-vape ko (But recently, I vape less) compared to how I vaped a few years ago, I was also a chain smoker. I learned how to control myself in terms of vaping na rin (too)," she added, noting that she only vapes when she is stressed out.

She made a promise to herself to quit eventually. "I'm actually waiting for the time na unti-unti na masanay katawan ko na pa-less nang pa-less ang vape (that my body gets used to slowly smoking vape) so I can fully quit."

Carl, who also requested anonymity, acknowledged the long-term risks.

"Knowing these can help push me to quit smoking and vaping," he added.

'Anytime, anywhere'

While most schools prohibit vaping inside their vicinities, Gab Oblefias, a lecturer, lamented that some students do not respect "no vaping signs" posted all over the campus.

"Ngayon nakakahuli ako ng students na nagva-vape sa loob mismo ng campus (Now I catch students vaping right inside the campus)," he said.

"Sa comfort room, sa mga fire exit, maging sa open grounds, pati sa empty classrooms. Kahit naman may mga karatula na nagsasabing bawal mag-vape, di naman effective yun kasi di rin naman ganoon ka-strict sa pag-scan ng gamit nila pagkapapasok sa campus (In the comfort room, in the fire exits, even in the open grounds, and even in the empty classrooms. Even though there are signs saying that vaping is prohibited, it’s not effective because the schools are not that strict in scanning their stuff after entering the campus)," he added.

While also a vape user himself, Oblefias said the lack of boundaries or respect concerns him.

"Kasi kahit di kasing baho ng traditional na yosi, obvious pa rin naman yung amoy gawa nung artificial scent na usok (Because even though it’s not as stinky as the traditional cigarette, it still smells because of its artificial scent smoke)," he said.

"Kung titingnan ko naman ito as a vape user, baka kasi yung accessibility at convenience ng vape, nakakadagdag yun sa lack of boundaries. Kasi kahit saan ka umupo, pumuwesto, pwedeng-pwede mo gawin (If I look at it as a vape user, maybe the accessibility and convenience of vape adds to the lack of boundaries. Because no matter where you sit or stay, you can vape)," he added, noting that vapes' accessibility makes the habit a lot easier to adopt than smoking because "one could do it anytime, anywhere."

Countries like India, Indonesia, Ireland, Kyrgyzstan, Morocco, Qatar, Syria, Saudi Arabia, and Ukraine have successfully implemented nicotine-free campus policies.

But can the Philippines follow suit?

Rebie Relator, president of Parents Against Vape, said Baguio schools now do surprise bag checks for e-cigarettes. The city’s ordinance implements an ordinance that prohibits the use, sale, distribution, and advertising of tobacco in all products. The ordinance also regulates the use and sale of vape products.

Relator also cited a school in Baguio that had to expel a student for violating the school’s memorandum.

“May isa talagang bata na in-expel ng school just because of this. So hindi naman yun one time lang, talagang binigyan din ang chance one time (There was one student in there who was expelled because of violating it, but the student was still given a chance),” she said.

“Tapos pinatawag ang parents, second time, pinatawag ulit ang parents tapos may ginawang iba pang action. Third time talaga aware pati ang patient at ang student na kung may third time pa, expulsion talaga ang gagawin (Then the student violated the memorandum again for the second time, so the school called their parents. The student and the parents were both made aware that when a third time occurs, there will be an expulsion. But the student still did it),” she added.

Relator said she thinks more schools should implement a memorandum against vaping.

“Kasi mahirap din kapag puro lang words, verbal, ganyan. Tapos walang kaukulang action (Because it’s hard too when we’re just all talk and we can’t act against it),” she added.

‘It should start at home’

Teacher Earnest Tiempo said he hopes there could be stricter regulations on vapes like the ones implemented against cigarettes.

However, Tiempo argued that government rules on using and possessing vapes among minors would not be effective if parents or guardians take no measures at home.

"Parents must be vigilant to ensure that these young ones using vapes have little to no access to them," he added.

Relator agreed, saying that regulation should start at home and parents should lead by example.

"Dapat walang naninigarilyo or nagva-vape at home. Dapat [din] maging supportive ang environment natin (At home, no one should be smoking or vaping. Their environment should also be supportive),” she pointed out.

However, she also admitted that parents and guardians can only do so much.

“[Because] once the kids are out of the home, nasa school sila or with friends, doon nangyayari kadalasan ang mga ganitong nagkakaroon ng peer pressure o napupunta sa mga bisyo. So kami as parents, we really say, we lead by example. Dapat wala talaga within the family [ang naninigarilyo] (Because once the kids are out of home, when they are at school or when with friends, these things happen, when they are under peer pressure or introduced to other vices. So us parents, we really say, we lead by example. No one within the family should smoke),” Relator said.

She added that other parents should also be educated about vape products because some are not aware, noting that some parents and guardians mistake vape products for just mere flashdrives.

“Isa rin yun sa mga advocacy namin na ituro sa kanila how to detect. Kasi minsan diba mga maliliit na lang ngayon, parang [flashdrive], parang kwintas (It’s also one of our advocacies, to teach parents how to detect vape products. Because sometimes, they look like flashdrives or necklaces),” she continued.

Relator also encouraged parents to work closely with school administrators and appeal for stricter regulations against vaping and possession of vape products.

“One is surprise na magkukumpiska or mag-check lang ng mga bags, ganyan (One suggestion is to confiscate vape products and to check students’ bags).”

What needs to be done

Public health advocacy group HealthJustice Philippines has been actively lobbying Filipino lawmakers to implement a tobacco tax on vapes and heated tobacco products.

Dr. Jaime Galvez Tan, former Health Secretary and HealthJustice Board Member, said a more decisive action should also be taken against e-cigarettes.

"We must counteract the deceptions because vapes can kill and are not a healthier alternative," he stressed.

Republic Act No. 11900, or the Vaporized Nicotine and Non-Nicotine Products Regulation Act, regulates the importation, sale, and use of electronic cigarettes and other vaping products, aiming to protect citizens from potential hazards and prevent sales to minors.

The law, also known as the Vape Law, which was enacted in 2022 and took full effect in 2024, is being enforced by the Department of Trade and Industry (DTI). The Vape Law also prohibits the sale of vape products near schools.

However, Limpin and Relator both appealed to raise the legal age of vaping to 25 years old, from the current 18 years old.

Another recommendation to address the ongoing vapedemic is to designate the Food and Drug Administration as the sole regulator of vape products, instead of the DTI, according to Limpin.

This story was produced under the “Communicating NCDs” Media Fellowship by Probe Media Foundation Inc. (PMFI), Reporting ASEAN (RA), and the World Health Organization (WHO). The views and opinions expressed in this piece are not necessarily those of PMFI, RA, and WHO.