By Aruna Sharma
In a major victory for public health proponents worldwide, a new bill introducing risk proportionate regulation of non-combustible alternatives to cigarettes recently became law in The Philippines. It is interesting to hear about this development as we near the three year anniversary of India putting a blanket ban on all electronic cigarettes and other products. It provides us with an opportunity to look at global developments, and the impact of India’s blanket ban legislation in the past three years.
In the Philippines, the Vaporized Nicotine and Non-Nicotine Products Regulation Act (VNNP Regulation Act), became law on 25 July 2022, two years after it was introduced in Congress. The act establishes a comprehensive regulatory framework for products such as e-cigarettes and heated tobacco products. In contrast, in 2019, India enacted The Prohibition of Electronic Cigarettes Act which put a blanket ban on production, manufacture, import, export, transport, sale, distribution, storage and advertisement of vaping devices.
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India is home to the world’s second largest tobacco use population, with over one in four adults consuming tobacco, and every tenth adult Indian smoking tobacco. The ban on vapes in India was effectuated on the pretext of protecting the youth from an addictive and potentially equally harmful product as conventional cigarettes. However, the ban has been a glaring failure in achieving its policy objectives, and illegally manufactured or smuggled vapes are commonplace in all major cities.
While the primary focus of healthcare in India is on providing preventive health care, better infrastructure in villages, hygienic habitats, better sanitation, toilets and safe drinking water, there is also an ongoing effort to reduce usage of tobacco and to shift smokers to less harmful options as a transitory phase towards complete cessation. The ill effects of tobacco have reams of papers and research publicly available, yet a smoker is not convinced unless they themselves or someone dear suffers from tobacco related illnesses.
ITC has 80% of the market share in growing tobacco, and the Indian government owns a reported 28.5% of the Indian behemoth via direct and indirect ownership. Thus, with the government directly benefiting from the production and sale of tobacco, it becomes its prerogative to ensure that less harmful tobacco products are also available on the market, and that new technological innovations to aid in tobacco cessation are not stifled.
It is also worth noting that as tobacco and nicotine use have traditionally gone hand in hand, one fine distinction between the two has largely escaped public discourse and attention. It is tobacco that is the enemy, not nicotine. Combustion of tobacco releases over 70 known carcinogens, but nicotine is not one of them. Nicotine, while addictive in nature, is not a carcinogen.
There has been significant scientific literature that has been put forth on the health impacts of vapes in the last few years. Owing to this, many countries – some with the most successful tobacco control policies – have come to accept the public health benefits that can be reaped from making evidence based policy on vapes. The UK, New Zealand, Japan, and Germany for example, have all accepted the use of either vapes or heated tobacco products (or both) as part of their tobacco control programs.
This is where the Philippines has taken a giant stride in benefitting its population. 28% of Filipinos – much like 29% of Indian adults – use tobacco in some form. While the Philippines has introduced legislation on par with countries with the most successful tobacco control programs, India on the other hand has moved backwards in its tobacco control efforts by adopting knee-jerk, regressive policies around vapes and heated tobacco products for the past three years.
India can take a leaf out of the Philippines playbook, and study and accordingly introduce policy and regulation in line with the latest evidence arising out of the use and acceptance of reduced harm tobacco products globally. While eliminating tobacco use completely remains the end game, smokers should have access to less harmful alternatives as they can prove a useful stepping stone to complete cessation.
The author is a Practitioner Development Economist and former Secretary, Government of India.
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