The government has also introduced larger pack warnings, expanded cessation services, strict enforcement of COTPA and revised guidelines for tobacco free educational institutions, he added.
Bringing an ordinance to ban e-cigarettes was an urgency as vaping was turning into an epidemic amongst the youth and allowing such products would have seriously undermined the government’s tobacco control efforts, Union Health Minister Harsh Vardhan said. Voicing confidence that the ban on e-cigarettes will be highly effective as the consumer base is small at present, he said taking the ordinance route was an approach to nip the problem in the bud. On September 18, the government issued an ordinance making the manufacturing, production, import, export, distribution, transport, sale, storage or advertisements of such alternative smoking devices a cognizable offence, attracting jail term and fine. “The success of ban depends upon the size of consumer base. Larger the size, lesser is the success rate of a ban…e-cigarettes have a small consumer base and bans will be highly effective,” the minister told PTI in an exclusive interview.
Only 4 per cent of population in India smokes cigarettes. The other 96 per cent, especially youth and adolescents are at risk of nicotine addiction through use of e-cigarettes. “ENDS have a net negative impact on public health, hence the ban,” he said, adding aggressive steps are necessary against these products that risk exposing a new generation of young people to nicotine. Quoting Global Adult Tobacco Survey (GATS 2) 2016-17, Vardhan said there are 270 million adult tobacco users in India who require their nicotine fix many times in a day while an estimated 0.02 per cent Indian adults use e-cigarettes. The minister explained that Electronic Nicotine Delivery Sytems (ENDS) like e-cigarettes are “common among never-smokers” who use these products as means of recreation.
When used by those who have never smoked conventional cigarettes before, these are known to be a gateway products leading to tobacco use and potentially other drugs’ use. “When used by current smokers, it only prolongs their nicotine dependence and deprives them a chance of an addiction-free life. Moreover, it is likely to revive the declining smoking rates by luring former smokers to re-initiate nicotine dependence,” Vardhan said. The minister further said India had 53 million adult cigarette smokers in 2016 (GATS-2, 2016), making it a “lucrative market for firms such as Juul and Philip Morris International” for introduction of these alternative means “to not only sustain nicotine dependence among current smokers in the name of harm reduction but also to target new customers by creating the perception that e-cigarettes are “safe”. “Introduction of e-cigarettes, these being gateway products, would have seriously undermined our tobacco control efforts,” he asserted.
As per GATS-2, India has shown 17 per cent relative decrease in tobacco consumption between 2010 and 2016, the steepest-ever reported in any part of the world. Asked about allegations by some section of the industry and users that the government banned e-cigarettes to protect the interest of conventional cigarette industry, Vardhan said, “This is simply not true”. He said that government has taken several measure to curb consumption of conventional tobacco. For instance, gutka has been banned across the country and 11 states have prohibited flavoured smokeless tobacco. India is the first country to make sale of tobacco to minors a non-bailable offence with seven years of rigorous imprisonment.
The government has also introduced larger pack warnings, expanded cessation services, strict enforcement of COTPA and revised guidelines for tobacco free educational institutions, he added. Rubbishing claims that e-cigarettes are safer and less harmful as compared to traditional cigarettes, Vardhan said smoking e-cigarettes is not approved as cessation devices anywhere in the world. In fact the e-cigarettes industry, in order to skip the scrutiny of their safety and “harm reduction” claims, maintains these are not “drugs” under the Drugs and cosmetics Act or federal drugs laws across the world. “There is no conclusive evidence to suggest that e-cigarettes are safer or less harmful than conventional cigarettes.
On the other hand, there is ample evidence of harm due to use of e-cigarettes, both on personal and public health,” he said. He referred to a white paper published by the Indian Council of Medical Research (ICMR) in which it concluded that ENDS or e-cigarettes and other like devices contains nicotine solution, which is highly addictive and contains harmful ingredients and thus recommended a complete ban on such products. The ICMR emphasised that use of ENDS or e-cigarettes has documented adverse effects on humans which include DNA damage, carcinogenesis, cellular, molecular and immunological toxicity, respiratory, cardiovascular and neurological disorders and adverse impact on foetal development, pregnancy, infant and child brain development. Nicotine exposure during adolescence can affect learning, memory, and attention, he said.
The ICMR’s white paper is comprehensive. An expert group constituted by the Ministry to study the health impact of e-cigarettes has also concluded that there is definite evidence of harm due to use of e-cigarettes, Vardhan said. “The current crisis of severe lung disease due to vaping in USA as reported by the Centre for Disease Control (CDC), Atlanta, wherein there have been more than 800 cases of lung sickness and 12 deaths in 2019 alone, confirms that use of e-cigarettes can severely impact health,” he said.