In a milestone move that would have an exponential impact, the government of India has protected generations from nicotine addiction, reiterating its commitment to protect and promote health and wellness among its citizens, especially young people. While the ordinance to ban e-cigarette came into effect on September 18, 2019, it continues to be widely debated and discussed in the country. The Hon’ble Prime Minister, in his speech at the 74th session of the UN General Assembly’s Universal Health Coverage meeting, proudly stated that the growing craze of e-cigarettes in India was worrisome, and therefore, to protect the youth from this grave danger, India has banned e-cigarettes.
The political will to get rid of this menace is very high, and tobacco control experts have widely applauded it; however, many experts, doctors and organizations are questioning the ban. They all argue about the harm—reduction aspect of e-cigarette over traditional cigarettes. The mainstream and social media are flooded by this harm-reduction lobby citing individual rights, safer alternatives, calling them a de-addiction tool and many more ill-informed and industry-supported arguments.
The efficacy and safety of e-cigarette as a quitting aid have not yet been firmly established by research. Dr Pankaj Chaturvedi, from Tata Memorial Hospital, says “Tobacco’s lobby argument on e-cigarettes being less harmful is based on a study which was completely flawed, and authors had a serious conflict of interest. ENDS was indeed a golden goose for the industry.” The tobacco industry was creating an additional market segment for nicotine-based products as well as sustaining the existing cigarette market. Cigarette and Other Tobacco Products Act, 2003 was litigated heavily by the tobacco industry, and even after 16 years, enforcement remains a deep concern. Therefore banning is the right step!
The tobacco industry has always been one step ahead of all regulations; gutkha (tobacco) ban is a case example. Gutkha was banned by FSSAI in 2011, following which, the Supreme Court also gave strict directives of enforcement. To circumvent the ban, gutkha companies started selling pan masala separately with pure tobacco—for the users to mix and chew. Recently, the National Tobacco Testing Laboratory has also found nicotine in many pan masalas, contrary to what the packaging claims. A similar regulation on e-cigarettes would become challenging, as it would lead to more legal battles, and testing and enforcement nightmares for the officials.
Therefore, it was imperative to ban e-cigarettes before they take over the population, and addict a large section like gutkha did in the 90s. A complete ban will make it inaccessible to the youth. Most definitely, e-cigarette companies will continue illicit trade, we have already observed this happening over WhatsApp widely in Delhi. However, the high prices and the inaccessibility will be a deterrent in access to youth. Eventually, they will not be seen sold or promoted and used!
India has taken long strides in the last decade with a 17% relative reduction in overall tobacco use prevalence and about 23% relative reduction in smoking prevalence alone, between the two GATS, India. The prevalence of e-cigarette smoking is only 0.02% as of the latest GATS (2016–17). Hence, it is obvious that vaping did not have any role whatsoever in reducing the smoking prevalence during the seven years between two GATS.
Dr Rijo John, a leading expert in the economics of tobacco control states “India doesn’t need vaping as a tool or strategy for tobacco harm reduction. We can achieve tobacco harm reduction and have done it without vaping.” The prevalence of tobacco users among minors aged 15–17 has also decreased substantially from 10% in GATS1 to 4% in GATS2, due to the multi-pronged strategies and work of the government and non-government organizations.
Cigarette companies that also own/fund most of the e-cigarette companies have also observed that initiation of cigarette smoking is reducing among the youth. Cigarette smoking is not a fad anymore, and children/youth are getting more aware of its ill-effects. Therefore, e-cigarette in the garb of harm-reduction is the perfect tool for them to ensure nicotine addiction remains high among the coming generations, and their profits continue to sore.
Is this a cost that all the vaping advocates are willing to bear—continuous and endless generations of nicotine addicts caught younger and younger in this trap?! Is this a cost worth the safer-alternative argument that current nicotine/tobacco addicts support? I would like to ask them, what would they prefer, safeguarding their health quitting tobacco themselves with proven alternative methods, or give tobacco companies the luxury to use them as fronts of harm-reduction strategies and allow them to continue to nurture future addicts?!
Seema Gupta, is a public health expert working on issues of Tobacco control and Maternal Child Adolescent Health. The above article was first published here.