Banning e-cigarette puts public health at risk, say experts

New Delhi: The two eminent Indian medical researchers have called upon the government to regulate electronic nicotine delivery devices (ENDS) or e-cigarettes in India instead of banning it outright without collecting any research data from India. They say that public health in India is at greater risk under a prohibitive environment than by allowing smokers, who wish to cease tobacco use, an alternative option based on nicotine replacement via e-cigarettes.

In an appeal to Mr J P Nadda, Minister of Health and Family Welfare, Government of India, Dr M Siddiqi, Chairman, Cancer Foundation of India, Kolkata and Prof R N Sharan, Professor of Biochemistry, North-Eastern Hill University, Shillong, have stated that while tobacco-associated cancer is easily preventable by cessation of tobacco usage, the primary cause of cancer is not nicotine – the additive component of tobacco and the cause of craving – but the constituents of the ‘smoke’ in combustible tobacco, and ‘other’ constituents in chewing tobacco.

The experts have urged the Union Minister of Health and Family Welfare that banning of e-cigarettes/ENDS could be disastrous for India which houses the second largest smoking population in the world (not including the bidi/ hukkah/ chilam smoking or tobacco/ areca nut chewing populations).

According to these scientists, the WHO prescribes nicotine in safe form as patches, gums, sprays, etc. – nicotine replacement alternatives – which is today a ‘gold standard’ for smoking cessation and tobacco control worldwide and not as another ‘addiction’ alternative. Unfortunately, poor efficacy of these products at population level has posed a challenge to all public health professionals globally, they say.

Both Dr Siddiqi and Prof. Sharan, in a joint letter to the Union Health Minister, have appealed that modern technology which delivers safe nicotine in an acceptable form should be looked at as an alternative nicotine replacement option. This includes electronic nicotine delivery systems (ENDS), popularly known as e-cigarettes, banning which, therefore, should not be thought of.

This view is increasingly accepted by several countries (EU, New Zealand, UK, USA, etc.), and their medical professionals and associations. In 2016, The Royal College of Physicians (UK) in its report titled ‘Nicotine Without Smoke’, published earlier this year, has brought out concrete medical data to substantiate this. The FDA (USA) and the COP7 (FCTC/COP7 (9) resolution, which India hosted last year endorsed a similar approach. Several countries are, for the first time, recording significant decline in smoking population after this safer form of nicotine delivery from ENDS/e-cig became available to people as a choice, among others, as a nicotine replacement option.

India, on the contrary, is seen to be thinking of banning this ENDS based modern technology, a move that the scientist duo have called to be potentially disastrous for public health. They have appealed to the government to regulate ENDS/ e-cigarette instead of banning it outright without collecting any research data from the population in the country.