Health Policy Commons^™

Strengthening Local Health Systems And Governance For Universal Health Coverage: Experiences And Lessons From The Covid-19 Pandemic Response In Quezon City, Philippines, Esperanza Anita Escano-Arias, Ramona Asuncion D.G. Abarquez, Rolando V. Cruz, Rosalie Espeleta, Madeline Mae Ong, Arianna Maever L. Amit, Veincent Christian Pepito, Vida Gomez, Manuel M. Dayrit

Ateneo School of Medicine and Public Health Publications

The COVID-19 pandemic has disrupted the Philippines's transition toward universal health coverage. However, some local government units in the country made use of the pandemic as a catalyst to strengthen their local health system, scale-up the provision of preventive and primary care services, and improve health governance to make it more prepared to face future pandemics and realize the aims of the country's new Universal Healthcare Act. This paper describes the response of the local government of Quezon City, Philippines, to COVID-19 and how it strengthened local health systems. We also discuss enablers such as partnerships, collaborations, and foresight to …

Preferences And Willingness For Starting Daily, On-Demand, And Long-Acting Injectable Hiv Pre-Exposure Prophylaxis Among Transfeminine Persons In The Us, 2022-2023, Duygu Islek, Travis Sanchez, Stefan Baral, Carolyn Brown, Joanna A. Caldwell, Jennifer L. Glick, Danielle Friedman Nestadt, Jeb Jones, Iaah L. Lucas, Supriya Sarkar, Annemiek De Ruiter, Patrick S. Sullivan, Mariah Valentine-Graves, Savannah Winter, Vani Vannappagari

School of Public Health Faculty Publications

Background There remains limited information concerning US transfeminine persons preferences across varying PrEP options. We examined PrEP option willingness, preferences, and associated factors among a US nationwide sample of transfeminine persons. Methods Sexually active transfeminine persons age 15 + were recruited online between June 2022-October 2023 through social media advertisements. Transfeminine persons not diagnosed with HIV were asked about willingness to initiate, and ranked preference, of three PrEP options- daily oral (DO), on-demand, and long-acting injectable (LA-PrEP). Log-binomial models were used to examine PrEP modality willingness and associated sociodemographic and behavioral characteristics. Results Among 2657 transfeminine persons not currently using …

A Novel Method For Semi-Quantitative Detection Of Hpv16 And Hpv18 Mrna With A Low-Cost, Open-Source Fluorimeter, Kathryn A Kundrod, Mary E Natoli, Chelsey A Smith, Jackson B Coole, Megan M Chang, Emilie Newsham Novak, Elizabeth Chiao, Elizabeth A Stier, Jane R Montealegre, Michael E Scheurer, Philip E Castle, Kathleen M Schmeler, Rebecca R Richards-Kortum

Center for Medical Ethics and Health Policy Staff Publications

Despite global calls to eliminate cervical cancer, rates of cervical cancer incidence and mortality remain high in resource-limited settings, where it is challenging to implement and sustain screening, diagnosis, and treatment programs. The presence of high-risk HPV mRNA in cervical cells is a sensitive and specific biomarker of cervical precancer. Yet, current testing methods are too costly and complex for use in resource-limited settings. Here, we present a novel method for semi-quantitative detection of HPV16 and HPV18 mRNA with minimal infrastructure requirements. The assay relies on isothermal reverse transcription recombinase polymerase amplification (RT-RPA) with real-time fluorescence readout, demonstrated on rugged, …

#Discreetshipping: Selling E-Cigarettes On Tiktok, Page D. Dobbs, Eric D. Schisler, Charlotte Mccormick

Health, Human Performance and Recreation Faculty Publications and Presentations

Introduction

Youth and young adult use of e-cigarette products continues to remain high despite regulatory approaches to reduce youth access. This study sought to examine TikTok content regarding the sale and distribution of e-cigarettes.

Aims and Methods

TikTok videos (n = 475) and metadata posted between June 2022 and August 2023 were scraped using a TikTok application programming interface and popular hashtags used to sell vaping products (ie, #discreetshipping [40.8 million], #puffbundle [14.8 million], #hiddennic [1.0 million]). After watching the 25 most viewed videos (39 600–868 800 views), a codebook was developed. All metadata were annotated using 11 unique …

"Health Gatekeepers": The Influence Of Women On Health Practices In Rural, Central Appalachia, Reese Lycan

Senior Theses

Women have historically assumed leadership roles in familial and community health promotion, intervention, and facilitation. While the role of women in family health is globally understood and the historical importance of female leadership has been documented, there remains a gap in knowledge regarding the role of women as “health gatekeepers”. Furthermore, when considering the Appalachian region, there are limited studies regarding women’s place in leadership as far as health is concerned. Therefore, this study employs a hermeneutic phenomenological framework to explore the lived experiences of women in relation to their family and community’s health in rural, Central Appalachia- a region …

Ethical Considerations For Sharing Aggregate Results From Pragmatic Clinical Trials, Stephanie R Morain, Abigail Brickler, Joseph Ali, Patricia Pearl O'Rourke, Kayte Spector-Bagdady, Benjamin Wilfond, Vasiliki Rahimzadeh, Caleigh Propes, Kayla Mehl, David Wendler

Center for Medical Ethics and Health Policy Staff Publications

A growing literature has explored the ethical obligations and current practices related to sharing aggregate results with research participants. However, no prior work has examined these issues in the context of pragmatic clinical trials. Several characteristics of pragmatic clinical trials may complicate both the ethics and the logistics of sharing aggregate results. Among these characteristics include that pragmatic clinical trials may affect the rights, welfare, and interests of not only patient-subjects but also clinicians, meaning that results may be owed to a broader range of groups than typically considered in other research contexts. In addition, some pragmatic clinical trials are …

Crispr/Cas9 Gene Therapy Increases The Risk Of Tumorigenesis In The Mouse Model Of Hereditary Tyrosinemia Type I, Tong Chen, Mercedes Barzi, Nika Furey, Hyunjae R Kim, Francis P Pankowicz, Xavier Legras, Sara H Elsea, Ayrea E Hurley, Diane Yang, David A Wheeler, Malgorzata Borowiak, Beatrice Bissig-Choisat, Pavel Sumazin, Karl-Dimiter Bissig

Center for Medical Ethics and Health Policy Staff Publications

Background & aims: The therapeutic potential of CRISPR gene editing has been demonstrated in various animal models; however, little is known about its long-term consequences. This study seeks to bridge this gap by investigating the lasting consequences of CRISPR gene therapy in an animal model of hereditary tyrosinemia type I (HT-I). We compared the standard of care-nitisinone, a small molecule inhibitor of hydroxyphenylpyruvate dioxygenase (HPD)-with the deletion of the Hpd gene by CRISPR gene therapy. Both treatments block flux through tyrosine catabolism and thereby prevent the accumulation of toxic catabolites in HT-I.

Methods: We assessed the efficacy and safety of …

Amniocentesis In Pregnancies At Or Beyond 24 Weeks: An International Multicenter Study, Roni Zemet, Mohamad Ali Maktabi, Alexandra Tinfow, Jessica L Giordano, Thomas M Heisler, Qi Yan, Roni Plaschkes, Jenny Stokes, Jennifer M Walsh, Siobhán Corcoran, Erica Schindewolf, Kendra Miller, Asha N Talati, Kristen A Miller, Karin Blakemore, Kate Swanson, Jana Ramm, Ivonne Bedei, Teresa N Sparks, Angie C Jelin, Neeta L Vora, Juliana S Gebb, David A Crosby, Michal Berkenstadt, Boaz Weisz, Ronald J Wapner, Ignatia B Van Den Veyver

Center for Medical Ethics and Health Policy Staff Publications

Background: Amniocentesis for genetic diagnosis is most commonly done between 15 and 22 weeks of gestation but can be performed at later gestational ages. The safety and genetic diagnostic accuracy of amniocentesis have been well-established through numerous large-scale multicenter studies for procedures before 24 weeks, but comprehensive data on late amniocentesis remain sparse.

Objective: To evaluate the indications, diagnostic yield, safety, and maternal and fetal outcomes associated with amniocentesis performed at or beyond 24 weeks of gestation.

Study design: We conducted an international multicenter retrospective cohort study examining pregnant individuals who underwent amniocentesis for prenatal diagnostic testing at gestational ages …

H.B. 22-1326: Analysis Of Colorado’S Fentanyl Policy, William Morris

Undergraduate Theses, Capstones, and Recitals

Fentanyl is one the most potent drugs on the market, its synthetic nature makes it is one of the deadliest at the lowest quantities. Many of its injectors are entirely unaware of its existence when they consume cocaine, methamphetamine, Xanax, ecstasy, and heroin. Nationwide and within Colorado, the use of synthetic fentanyl has perpetuated a crisis that threatens the health and safety of numerous communities, with both fatal and non-fatal overdoses continually on the rise. In 2022, Colorado passed H.B. 22-1326, aimed at curbing fentanyl deaths and non-fatal overdoses, by further criminalizing fentanyl possession. Understanding the effectiveness of felony-heavy drug …

A Narrative Review Of The Covid-19 Infodemic And Censorship In Healthcare, Mitchell Liester, Sohaib Ashraf, Patricia Callisperis, Hector Carvallo, Shankara Chetty, Robert Enzenauer, Carlos Franco-Paredes, Raul Pineda, Panagis Polykretis, Rachel Wilkenson, Peter Mccullough

Secrecy and Society

Ideological and financial motivations have undermined science for decades. In this narrative review, we explore how organizations and governments used misinformation, disinformation, censorship, and secrecy to manage the COVID-19 pandemic. Various rationales for employing censorship and secrecy during the COVID-19 pandemic are examined including how organizations and governments create confusion about the risks associated with their products and blame avoidance to shift responsibility and to avoid accountability for their actions. Methods of censorship employed during the COVID-19 pandemic are reviewed, examples are provided, and the consequences of these actions are reviewed. Information included in this review was obtained from scientific …

Covid Cover-Up: Secrecy, Censorship And Suppression During The Pandemic, Brian Martin

Secrecy and Society

During the height of the COVID-19 pandemic, most health authorities, governments, and mass media organizations presented a single official view concerning lockdowns, masking, distancing, and vaccines. The methods used against contrary views can be classified into four types: flooding, ignoring, censoring, and attacking. The method of information flooding involves presenting dominant views in a unified front, overwhelming contrary views by volume and consistency. The method of ignoring includes the absence of research on alternative approaches, failure to report on research contrary to orthodoxy, and not mentioning challenging views. Censoring involves active measures to prevent the circulation of contrary information and …

Association Of Messenger Rna Coronavirus Disease 2019 (Covid-19) Vaccination And Reductions In Post Covid Conditions Following Severe Acute Respiratory Syndrome Coronavirus 2 Infection In A Us Prospective Cohort Of Essential Workers, Josephine Mak, Sana Khan, Amadea Britton, Spencer Rose, Lisa Gwynn, Katherine D Ellingson, Jennifer Meece, Leora R Feldstein, Harmony Tyner, Laura J Edwards, Matthew S Thiese, Allison Naleway, Manjusha Gaglani, Natasha Solle, Jefferey L Burgess, Julie Mayo Lamberte, Meghan Shea, Taryn Hunt-Smith, Alberto Caban-Martinez, Cynthia Porter, Ryan Wiegand, Ramona Rai, Kurt T Hegmann, James Hollister, Ashley Fowlkes, Meredith Wesley, Andrew L Philips, Patrick Rivers, Robin Bloodworth, Gabriella Newes-Adeyi, Lauren E W Olsho, Sarang K Yoon, Sharon Saydah, Karen Lutrick

Center for Medical Ethics and Health Policy Staff Publications

Background: Data are limited on whether vaccination reduces post COVID conditions (PCCs) risk after less severe nonhospitalized coronavirus disease 2019 (COVID-19). This study assessed whether COVID-19 vaccination protected against PCCs in persons with mild initial infections during Delta and Omicron variant predominance.

Methods: This study utilized a case-control design, nested within the HEROES-RECOVER cohort. Participants aged ≥18 years with test-confirmed severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) between 28 June 2021 and 14 September 2022 were surveyed for PCCs, defined by symptoms lasting >4 weeks after initial infection. Cases self-reported PCCs and controls self-reported no PCCs. The exposure was …

Mobilizing Prevention And Early Detection Of Alzheimer's Disease And Related Dementias (Adrd) In Allegheny County Through The Area Agency On Aging (Aaa), Laiba N. Mirza

Public Health Capstone Projects

1. Objectives: In collaboration with the Department of Human Services (DHS): the Area Agency on Aging (AAA) using the Healthy Brain Initiative (HBI), my capstone project will involve the development of a comprehensive literature review examining the impacts of Alzheimer’s disease and related dementias (ADRD) on patients and their caregivers. The project aims to help the AAA focus on strategies to delay the onset of ADRD in Allegheny County. It also seeks to evaluate and enhance early detection programs for ADRD established by the AAA in communities within the county. Additionally, the project will explore how public health initiatives can …

Health Equity & Parental Leave: Addressing Gaps In Maternal Health Policy, Destiny L. Smith

Public Health Capstone Projects

Objective: This capstone project at Duquesne University will address health equity by focusing on employer-provided maternal and parental leave policies in the United States among underserved groups. It aims to address the gaps in these policies and analyze how disparities in leave policies across different industries can impact maternal and infant health outcomes.

Priority Population Served: This study will primarily target underserved employees who had to take some type of leave policy while working for an intended employer.

Methods: This project will engage in data analysis of the 2024 BIRTH survey results that the Pittsburgh Business Group on …

Assisted Reproductive Technology (Art) In The Mountain West, 2022, Caitlin J. Saladino, Kristian Thymianos, William E. Brown Jr., Monserrat Cristando-Romo, Taylor Volk, Yashesvi Sharma

Health

This fact sheet examines data on Assisted Reproductive Technology (ART) clinics located in five Mountain West states: Arizona, Colorado, Nevada, New Mexico, and Utah. The Centers for Disease Control and Prevention 2022 Fertility Clinic Success Rates Report includes data from all 50 states and provides information on ART services offered by individual clinics, including data on total cycles, fertility preservation cycles, pregnancies, deliveries, and total infants born.

National Cancer Centers And Cancer Rates In Nevada, 2017-2021, Yashesvi Sharma, Ivan Sun, Taylor Volk, Caitlin J. Saladino, William E. Brown Jr., Fatma Nasoz

Health

This fact sheet presents data from the National Institutes of Health including the National Cancer Institute’s (NCI) “State Cancer Profiles” report and includes age-adjusted cancer incidence rates by race/ethnicity in Nevada, between 2017 and 2021. The fact sheet also shows data from the 2024 National Cancer Institute’s “NCI-Designated Cancer Centers” map, listing NCI-Designated Cancer Centers by state, and the distance to the nearest NCI-Designated Cancer Centers from the Las Vegas metro and Reno metro.

Evaluating Industry Relationships And Transparency: Insights From Orthopedic Surgeons In The Cms Open Payments Database, Anesu K. Murambadoro, Mario Keko, Edward Rodriguez, John J. Wixted

Research Symposium

Introduction: Industry payments to physicians may risk introducing bias into patient care. The Open Payments (OP) database, established by Physician Payments Sunshine Act, reports these payments to promote transparency. Orthopedic surgeons receive the highest industry payments especially in the category of royalties/licensing, prompting questions about conflicts of interest and whether the database accurately reflects the status across the specialty. We hypothesize that the OP database underrepresents the relationships that orthopedic surgeons have with industry. We seek to assess the validity of reported industry payments, particularly in the categories of royalties and licensing payments to determine how to improve transparency and …

Analysis Of Systematic Trade-Offs Between Military And Healthcare Expenditure Alongside Gdp Growth Of Select Asian And Western Exporting Economies In The 21st Century, Rahul Balamurugan, Carlos Gershenson, Preethi Nanjundan, Hiroki Sayama

Northeast Journal of Complex Systems (NEJCS)

This study explores the complexity in the trade-offs between military expenditure, healthcare expenditure, and GDP growth across select Asian nations and major weapon-exporting countries, examining how nations allocate finite resources between national security and human well-being over the past two decades. Using a systems science approach, the research integrates Granger causality testing to analyze temporal and directional relationships among GDP growth, military expenditure, and healthcare expenditure, uncovering their dynamic interdependencies. The methodology includes trend and slope analysis, Granger causality testing, outlier detection, and clustering to identify heterogeneity in resource allocation strategies. Developed, weapon-exporting nations exhibit complementary trends, with strong causality …

Community Centered Funding Models For Maine, Timothy Atkinson, Jillian Foley, Jane Rooks

Justice Policy

This report is an exploration of literature and frameworks for local community-driven funding strategies to improve Maine’s public health outcomes. The authors present a number of community-led funding theories such as place-based funding models and participatory grant making, examine lessons learned from recent public health events, and discuss reflections from interviews with key stakeholders. The report looks at examples of community-led models and makes recommendations for next steps such as improving collaborative relationships, strengthening peer-to-peer networks, expanding availability of flexible funding that includes backbone support, and conducting a cost-benefit analysis of collaborative community health capacity investment options.

Patient Consent And The Right To Notice And Explanation Of Ai Systems Used In Health Care, Meghan E Hurley, Benjamin H Lang, Kristin Marie Kostick-Quenet, Jared N Smith, Jennifer Blumenthal-Barby

Center for Medical Ethics and Health Policy Staff Publications

Given the need for enforceable guardrails for artificial intelligence (AI) that protect the public and allow for innovation, the U.S. Government recently issued a Blueprint for an AI Bill of Rights which outlines five principles of safe AI design, use, and implementation. One in particular, the right to notice and explanation, requires accurately informing the public about the use of AI that impacts them in ways that are easy to understand. Yet, in the healthcare setting, it is unclear what goal the right to notice and explanation serves, and the moral importance of patient-level disclosure. We propose three normative functions …

Family Genetic Risk Communication And Reverse Cascade Testing In The Babyseq Project, Melissa K Uveges, Hadley Stevens Smith, Stacey Pereira, Casie Genetti, Amy L Mcguire, Alan H Beggs, Robert C Green, Ingrid A Holm

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Genomic sequencing of newborns can initiate disease surveillance and therapy for children and may identify at-risk relatives through reverse cascade testing. We explored genetic risk communication and reverse cascade testing among families of newborns who underwent exome sequencing and were identified as having a risk for an autosomal dominant disease.

Methods: We conducted semistructured interviews with parents of newborns enrolled in the BabySeq Project who had a pathogenic or likely pathogenic variant associated with an autosomal dominant childhood- and/or adult-onset disease returned. We used directed content analysis to derive themes.

Results: From 11 families, all first-degree relatives (n = …

Navigating Your Us Bioscience Career Into The 2030s, Peter J Hotez

Center for Medical Ethics and Health Policy Staff Publications

The coming decade might see major cuts to the United States Government funding for biomedicine and the mainstreaming of pseudoscience. But your biosciences PhD gives you the problem-solving skills to navigate this maelstrom, especially if you maintain flexibility, optimism, and enthusiasm for uncharted paths.

Thai Sugar-Sweetened Beverage Tax: Does It Really Help?, Sitaporn Suriya, Buraskorn Torut

Kesmas

A solution recommended by the World Health Organization to prevent and control noncommunicable diseases is the Sugar-Sweetened Beverage (SSB) tax. This study aimed to evaluate the Thai SSB tax efficiency affecting the change in post-tax individual-level consumption and find causal explanations for the people’s consumption behavior after the SSB tax was implemented. This study used a Productivity Model, and stratified random sampling was conducted by selecting 1,200 people. An in-depth interview was conducted to seek causal explanations for post-SSB tax consumption behavior with 15 key informants. The results revealed the SSB tax’s efficiency in terms of perception and understanding at …

Exploring Physician Well-Being: A Bibliometric Analysis Of Mental Health, Suriya Kumareswaran, Bala Murali Sundram, Vanitha Thurairasu

Kesmas

This bibliometric study examined the evolving research landscape on physician mental health from 2010 to 2023, analyzing key themes, publication trends, and global contributions. A total of 3,360 articles, including 3,137 original research and 223 reviews, were sourced from Web of Science and Scopus. Findings revealed a significant increase in research output, particularly during the COVID-19 pandemic, with burnout, depression, and anxiety emerging as dominant themes. The US accounted for most publications, while research from low- and middle-income countries remains limited, indicating a substantial global disparity. Thematic analysis highlighted variations in burnout assessment methodologies, underscoring the need for standardized evaluation …

Five-Year Journey Of Technical Assistance In Health Governance Reforms: A Case Report, Popy Yuniar, Indang Trihandini, Ibnu Muyassar, Latifatul Khoiriyah, Minawati Minawati, Fathiyya Aliyah Birjaman, Tyra Septi Diana, Annabel Serafina, Hertina Raisa Putri, Rana Maimunah, Riko Setiawan, Nadazaira Alifia Ramadhianisa, Aris Diyanto

Kesmas

Many districts and cities in Indonesia continue to have Public Health Development Index scores below the national average, highlighting the need for improved health governance. This study assessed the five-year impact (2019–2023) of a mentoring program for 149 District Health Offices in preparing annual work plans, focusing on stagnation or performance declines. Using a qualitative approach, the study analyzed annual work plan scores before and after technical assistance, conducted focus group discussions, and carried out in-depth interviews to identify challenges. Key barriers included data management issues, weak advocacy, knowledge transfer gaps, and poor cross-sectoral coordination, which hindered decision-making and program …

Public Health Entrepreneurship In Indonesia: What Is Next?, Hadi Pratomo, Roy Darmawan, Karina Samaria

Kesmas

Public health has been demanded to search for ways to improve well-being by tackling societal and ecological factors that influence health through cooperative strategies and partnerships across various fields. More interdisciplinary, interprofessional, and action-oriented approaches toward sustainable public health programs are recommended to be made. Therefore, public health entrepreneurship is an indispensable approach to creating new interventions that address future public health problems. The Indonesian Ministry of Health conceptualized five public health entrepreneurship skills as standard competence for public health personnel. In addition, the Association of Indonesian Public Health Higher Education Institutions has identified several study materials and learning outcomes …

Socio-Epidemiological Perspectives Of Sexual Trauma Experiences And Influential Factors On Sexual Orientation In Men Who Have Sex With Men, Rico Januar Sitorus, Misnaniarti Misnaniarti, Legiran Legiran, Rizma Adlia Syakurah, Diana Dewi Sartika, Asri Maharani, Retta Patresia

Kesmas

The complexity of sexuality and sexual trauma experiences, including harassment, unwanted touching, sexual urges, and forced sexual intercourse, should not be underestimated because of the tendency to initiate adverse psychosocial impacts. Sexual harassment can increase mental health risks, which may influence sexual orientation decisions. This quantitative study, using a cross-sectional design, aimed to determine a relationship between sexual trauma experiences and sexual orientation in men who have sex with men (MSM). This study population was MSM living in Palembang and Prabumulih City, with a sample size of 216 respondents. The proportion of respondents with homosexual orientation was 57.1%, and the …

Determinants Of Adolescent Resilience Levels In Surabaya City, East Java Province, Indonesia, Riris Diana Rachmayanti, Fatwa Sari Tetra Dewi, Diana Setiyawati, M Dody Izhar, Andrei Ramani

Kesmas

Assessing adolescent resilience may provide valuable insights into adult resilience. This study aimed to analyze the relationship between determinants and adolescent resilience in Surabaya City. The participants of this cross-sectional study were 277 adolescents aged 12–19 years who were in senior high school. The outcome was the resilience levels. This study's findings indicated relationships between resilience levels and stress experience (p-value = 0.01), access to mental health information (p-value = 0.00), life satisfaction (p-value = 0.00), family harmony (p-value = 0.03), presence of adults to share (p-value = 0.04), feeling safe at home, school, and community (p-value = 0.00), perception …

Researching The U.S. Senate Presidential Nominee Confirmation Process, Bert Chapman

Libraries Faculty and Staff Presentations

The beginning of 2025 has seen renewed public attention and emphasis on the constitutionally mandated U.S. Senate confirmation process. This stems from the beginning of the second Trump Administration as its nominees navigate this process. The presentation provides historical background on this process, demonstrates what nominees, Senate oversight committees, and the full Senate in administering this process and enables readers to find out how to access information resources documenting this process. The confirmation process continues throughout presidential administrations and may involve little public attention and controversy or acute public attention and controversy. The contrasting 2025 confirmation experiences of Secretary of …

Examining The Flavor Descriptors Of E-Cigarettes, Heated Tobacco Products, And Nicotine Pouches In The Philippines: Regulatory Challenges And Opportunities, Samantha J. Ackary, Patrik James D.L. Cabrera, Alen Josef A. Santiago, Gianna Gayle H. Amul

Ateneo School of Government Publications

In the Philippines, the regulation of e-cigarettes, heated tobacco products (HTPs), and nicotine pouches under Republic Act 11900 or the Vape Law is crucial as their use continues to rise. As e-cigarettes are rapidly gaining popularity due to their social appeal, perceived novelty, ever-changing flavors, and sensations that are attractive to consumers, HTPs and nicotine pouches are continuously developing as well. This study aims to characterize e-cigarette, HTP, and nicotine pouch flavor descriptors in the Philippines and to assess the regulatory implications of existing policies regulating these products. We adapted the Tobacco Pack Surveillance System (TPackSS) data collection protocol developed …