E Cigarettes Ban in India, the Right step at the Right time !

Seema Gupta

In a milestone move that would have exponential impact, the Government of India has protected generations from nicotine addiction, reiterating its commitment to protect and promote health and wellness amongst its citizens, especially young people. While the E-cigarette ordinance ban came into effect on 18th Sept, 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, 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 it is being widely applauded by tobacco control experts. However, there any many experts, doctors and organizations who are questioning the ban. They all argue about the harm – reduction aspect of E-cigarette over traditional cigarettes. Mainstream and social media is flooded by this harm-reduction lobby citing individual rights, safer alternatives, de-addiction tool and many more ill-informed and industry supported arguments.

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, "The Tobacco's lobby argument on E cigarettes being less harmful is based on a study which was completely flawed and authors had serious conflict of interest. ENDS was indeed a golden goose for the industry." The tobacco industry was in fact 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 still remains a deep concern.

Tobacco industry has always been one step ahead of all regulations, Gutkha ban being 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.

It was imperative to therefore, ban E-cigarettes before they take over the population and addict a large section like Gutkha did in the 90s. A complete ban on E-cigarette 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-cigarettes smoking is only 0.02% as of the latest GATS (2016-17). Hence, it is very clear that vaping did not have any role whatsoever in reducing the smoking prevalence during the 7 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 amongst minors aged 15 – 17 has also decreased substantially from 10% in GATS 1 to 4% in GATS 2 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 amongst youth. Cigarette smoking is not a fad anymore and children/youth are getting more aware of its ill-effects. Therefore, E-cigarettes in the garb of harm-reduction is the perfect tool for them to ensure nicotine addiction remains high amongst coming generations and their profits continue to soar.

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 continue to nurture future addicts?

(Seema Gupta is a Public health expert working on issues of Tobacco control and Maternal Child Adolescent Health.)

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