Insights into Editorial: Smoking e-cigarettes is injurious to health
The World Health Organisation (WHO) has red flagged the growing market for e-cigarettes in India, underlining that the use of the devices is no less harmful than traditional cigarettes.
- Market research projects the compound annual growth rate of the Indian e-cigarette industry at 63.38% in the period 2013-2018 (Research and Markets Report on E-cigarette Market in India 2014-2018).
What are e-cigarettes?
An electronic cigarette (or e-cig) is a battery-powered vaporizer that mimics tobacco smoking. It works by heating up a nicotine liquid, called “juice.”
- Nicotine juice (or e-juice) comes in various flavors and nicotine levels. e-liquid is composed of five ingredients: vegetable glycerin (a material used in all types of food and personal care products, like toothpaste) and propylene glycol (a solvent most commonly used in fog machines.) propylene glycol is the ingredient that produces thicker clouds of vapor.
- Proponents of e-cigs argue that the practice is healthier than traditional cigarettes because users are only inhaling water vapor and nicotine.
Why are some countries banning e-cigarettes?
- Many states are banning the use of e-cigs indoors. Since e-cigs are new, there haven’t been enough studies conducted on the long-term health effects. Another argument against e-cigs is the candy-like flavors, which experts argue will lure children into smoking.
- Although they are projected as ‘tobacco cessation’ products by various sellers, including tobacco giants themselves, the lack of concrete evidence in support of this claim coupled with the absence of any regulatory approval for their use make them a serious public health threat.
What are the main concerns now?
- In India smoking devices are easily available through online shopping portals and with little information out in the public domain about the ill-effects of e-cigarettes there is a misconception that it is less harmful than traditional cigarettes.
- Smart marketing and inadequate information on the nicotine content in e-cigarettes has created a false impression that these devices are not as harmful as regular cigarettes. In the absence of a regulation the use of e-cigarettes has grown; they are easily accessible to even the non smokers.
- Along with the traditional cigarette manufacturing, there is a parallel industry of e-cigarette like devices growing in India, which is under-regulated.
- The WHO has also expressed concern over the notion that e-cigarettes aid in kicking the habit; it has cautioned that there is not enough evidence to conclude that e-cigarettes help users quit smoking.
Harmful effects of e cigarettes:
- Although they are generally thought to be less harmful than smoking real cigarettes, because they contain no tobacco, they do still contain the addictive chemical nicotine. Scientists have confirmed that e-cigarette vapours to contain the same potentially dangerous chemicals.
- Research has also confirmed that e-cigarette vapours contain free radical chemicals previously thought only to be found in tobacco cigarettes and air pollutants. Free radicals are highly reactive agents that can damage DNA or other molecules within cells, resulting in cell death. Cigarette smoke contains 1014 free radicals per puff. Though e-cigarette vapour contains far fewer free radicals than cigarette smoke – one percent as much – their presence in e-cigarettes still suggests potential health risks.
Why its hard to regulate them?
As e-cigarettes contain nicotine and not tobacco, they do not fall within the ambit of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA), which mandates stringent health warnings on the packaging and advertisements of tobacco products.
What needs to be done?
The current unregulated sale of e-cigarettes is dangerous for a country like India where the number of smokers is on the decline (WHO Global Report, 2015) as it increases the possibility of e-cigarettes becoming a gateway for smoking by inducing nicotine addiction and perpetuating smoking by making it more attractive, thereby encouraging persons to become users of tobacco as well as e-cigarettes.
- In the absence of clearer evidence on the effect of e-cigarettes on tobacco cessation, it is imperative that their sale be accompanied by accurate health warnings. This is especially relevant in India, where data in the Global Adult Tobacco Survey 2009-2010 suggests that tobacco control laws, particularly the pictorial health warnings and advertisements, mandated under COTPA, have been highly effective in increasing awareness of the health risks of tobacco (smoking as well as non-smoking).
- The government should also impose appropriate restrictions on the sale and advertisement, online and otherwise, of e-cigarettes, including proper health warnings, in order to plug the existing regulatory vacuum. This should be done with immediate effect, and simultaneously the government should also commission independent scientific research on the benefits and risks posed by these products in the Indian context.