E-cigarettes help only a fraction of smokers quit. More than three-fourths use it along with cigarettes, exposing them to double dose of nicotine.
By Pankaj Chaturvedi
The government has just banned e-cigarettes. While there has been much debate around this, the step is a sound one. E-cigarettes contain nicotine, which is a highly toxic chemical. Some states in India have included it in the schedule of poisonous substances. A dosage of 30-50 mg of nicotine can kill an adult human. Nicotine in pure form may also cause cancer. Nicotine sulphate was once approved to be used as a pesticide by the agriculture department. Recently, that approval was withdrawn, considering its toxicity. Therefore, it is a chemical that is not fit to be used even as a pesticide!
Nicotine is the most addictive substance currently known in the world—even more addictive than heroin. There is no treatment currently known for nicotine addiction. To counter the withdrawal symptoms of smoking, usage of small dosages of nicotine (2mg) under medical supervision for a short period of time has been approved. There are very few reports of long-term addiction to nicotine tables or gums. Over-the-counter sale of e-cigarettes will promote easy, and unregulated access to very high doses of nicotine for recreational, rather than medicinal use. Nearly 80% of those who start e-cigarettes to quit cigarettes can’t quit the e-cigarette. It deprives a quitter of a nicotine-free life despite successfully quitting cigarettes.
Contrary to claims of the e-cigarette lobby, e-cigarettes have not been approved as a cessation drug or tool. There is no conclusive study to support the claims of the e-cigarette lobby regarding its medical benefits. Such is the power of the misinformation campaign by the e-cigarette lobby that many noted doctors started believing the concept of “harm reduction”. It is equivalent to saying that jumping from the 10th floor is safer than jumping from the 13th floor. Less harm does not mean harmless.
E-cigarettes help only a small fraction of smokers quit. More than three-fourths use it along with cigarettes, in their futile attempt to quit smoking. This exposes them to double dose of nicotine. The majority of e-cigarette brands are produced/marketed/promoted by manufacturers of cigarettes themselves. Therefore, rather than challenging the government to ban tobacco, they should themselves stop manufacturing tobacco products. They are using their old tricks of deception, corruption, and misinformation to promote their new product. With declining cigarette usage, e-cigarettes are their new source of profit.
The countries that tried to regulate e-cigarettes are witnessing an unprecedented epidemic, for which they have no solution. It was acknowledged by none less than the US FDA chief. In a country like India, it is difficult to ban a product once it has a large consumer base, and social acceptance. The classic examples for this are tobacco, paan masala, alcohol, etc. Since e-cigarettes have a small consumer base, a ban will be highly effective. Lack of ban on tobacco cannot be the justification for introducing a new addiction, even though it may be less harmful.
There have been various reports of serious lung injury, and deaths due to e-cigarettes, within two years of its introduction, in the USA. Following such reports, it has been found that e-cigarette users are now switching to cigarettes. E-cigarettes are marketed in a way that is attractive to the youth and to kids, who are misled into believing that it is safe. After casual vaping, they get addicted to nicotine, and later graduate to cigarette smoking. In short, e-cigarettes serve as a gateway to the usage of cigarettes, often manufactured by the same company.
Considering that e-cigarettes are very expensive, with prices going up to Rs 3,000, many users switch to cigarettes (cheaper source of nicotine) when they are short of money, or their device is not functioning. E-cigarettes lure those smokers who have already quit cigarettes to re-initiate smoking (e-cigarettes), under the false notion that they are harmless.
India does not manufacture e-cigarettes or its ingredients. They are mostly imported. Therefore, the ban does not lead to any revenue loss for the nation. Considering that the cheapest source of nicotine is tobacco itself, it is nearly impossible to extract pure nicotine without any other harmful contamination. At the same time, it will be a mammoth task for regulators to test every product in a country where detection of contamination in food/water itself is far from satisfactory.
Rise in the share prices of cigarette companies is inconsequential because usage of cigarettes is declining steadily. The cigarette business is no longer profitable. Moreover, considering both traditional cigarette brands, and e-cigarette brands have the same owners, the rise in share prices may work in favour of the e-cigarette industry too.
The world over, governments are working towards reduction of tobacco cultivation due to its human and environmental hazards. Introduction of e-cigarettes will form the basis for the continuation of the tobacco cultivation. The country is already struggling with effective control of multiple addictions—tobacco, supaari, alcohol, cannabis, etc—among the youth. There is no need to introduce one more addiction among our future generation.
Deputy director, Centre for Cancer Epidemiology, Tata Memorial Centre, & secretary general, International Federation of Head and Neck Oncologic Societies.