Four-and-a-half years after India declared its “intention” to ban e-cigarettes, considering them as risk to public health, especially the non-smoking youths (click HERE),
following the World Health Organization (WHO) in August 2014 seeking
“stiff regulation” across the world, its “booming” $3 billion global
market appears all set to dangerously invade India.
The Union
ministry of health and family welfare, in October 2014 had called
e-cigarettes, which use battery-powered cartridges to produce a
nicotine-laced vapor, a “backdoor entry” to health risk, because has
nicotine, pointing out that expert panels have already recommended
regulation or a ban.
The ministry view came after e-cigarettes,
imported and sold by small firms, began being sold by India’s largest
cigarette maker, ITC. Meanwhile, over more than four years, they are
available on online stores, including on Amazon India, Electronic Cigarette India and Vapour India.
In
fact, four-and-a-half years on, all that the Government of India (GoI),
instead of banning the product, has done is to issue a feeble advisory
on August 28, 2018 to all states to consider banning e-cigarettes, which
it said, should be done “in larger public health interest” and in order
to “prevent the initiation of Electronic Nicotine Delivery Systems
(ENDS) by non-smokers and youth with special attention to vulnerable
groups”.
The advisory insisted, the states should do this to “ensure
that any ENDS, including e-cigarettes, heat-not-burn devices, vape,
e-sheesha, e-nicotine flavoured hookah, and the like devices that enable
nicotine delivery are not sold (including online sale), manufactured,
distributed, traded, imported and advertised in their jurisdiction.”
It
added, this was necessary because “there are possibilities that
children, adolescents & youth (and generally non-smokers) will
initiate nicotine use through ENDS at a rate greater than expected if
ENDS did not exist; and that, once addicted to nicotine through ENDS,
such children, adolescents & youth are likely to switch to cigarette
smoking.”
Following the advisory, while several states – including
Karnataka, Kerala, Punjab, Jammu and Kashmir, Mizoram and Maharashtra —
have banned e-cigarettes under the Drugs and Cosmetics Act, 1940, and
Food Safety & Standards (Prohibition and Restriction on Sales)
Regulation, 2011, GoI appears reluctant to take things forward.
In a
clear indication that the GoI would not pursue a blanket ban to save
non-smoking youths from a new health hazard, Vikas Sheel, joint
secretary, Ministry of Health and Family Welfare merely tweeted about the harms the e-cigarettes can cause on January 31, suggesting its effectiveness is still not “proven.”
He
said, “Effectiveness of e-cigarettes as cessation aides as compared to
other nicotine replacement therapy (NRT) tools is not proven. Such
claims are marketing propaganda of the ENDS companies to use these
gateway products for initiating youth on nicotine addiction.”
Meanwhile,
industry campaign for introducing e-cigarettes, despite clear harm it
may cause to the youth, has picked up. Among others, Dr KK Aggarwal,
president of the Heart Care Foundation of India, and past national
president, Indian Medical Association, has stated that the ENDS are “far less harmful than conventional cigarettes”.
He
says, “Tobacco harm reduction means action taken to reduce the health
risks associated with the use of tobacco or nicotine. It involves the
use of non-combustible products such as vaping ones like e-cigarettes,
heated tobacco products or smokeless tobacco. These products are
collectively called Alternative Nicotine Delivery Systems (ANDS) and do
not involve burning of tobacco leaf or smoke inhalation.”
The senior
doctor quotes a UK parliamentary inquiry into e-cigarettes reported on
August 17, 2018, which stated that “e-cigarettes present an opportunity
to significantly accelerate already declining smoking rates, and thereby
tackle one of the largest causes of death in the UK today. They are
substantially less harmful—by around 95 percent—than conventional
cigarettes.”
This contradicts the WHO view, which has expressed
skepticism about the effectiveness of ANDS as effective tools for
quitting, pointing out that, “with almost 8,000 different flavours
added, including fruit and candy-like flavours, there is legitimate
concern that instead of reducing the number of smokers, they will
actually serve as a gateway to nicotine addiction, and ultimately,
smoking, particularly for young people”.
However, says Dr Aggarwal,
the organization he heads, the Heart Care Foundation of India “feels
that, based on available evidence, using e-cigarettes is less harmful
than smoking cigarettes though the health effects of its long-term use
are not known.”
Even as GoI is failing to take any decision in the
matter, new, dangerous signals have come from the US. Juul Labs Inc has
reportedly revealed its plan
to launch its e-cigarette products in India by late 2019. The report
follows Uber India executive Rachit Ranjan joining as senior public
policy strategist with Juul, and India-based Mastercard executive Rohan
Mishra as head of its government relations.
The report says, Juul
plans to hire at least three more executives, including an India general
manager, LinkedIn job postings showed. It also plans “a new India
subsidiary”, according to one posting.
Juul’s sleek vaping devices,
which resemble a USB flash drive and offer flavours such as mango and
creme, are a sensation in the US, especially among the teenagers. Juul
devices, like most e-cigarettes, vaporize liquid containing nicotine,
the addictive stimulant that gives smokers a rush.
Even as
anti-tobacco activists say, Juul devices involve addictive chemicals and
can be a gateway to cigarette smoking, especially for the young, the
push to launch in India is said to be part of the company’s broader Asia
strategy, as India has 106 million adult smokers, second only to China
in the world, making it a “lucrative market”.
Juul sources have been
quoted as saying that the company is exploring “potential markets”, and
is already “engaged with health regulators, policymakers and other key
stakeholders”. And, as part of its evaluation, it would consult with the
Indian Journal of Clinical Practice (IJCP), a healthcare communications
company, one of whose editors is Dr Aggarwal.
While the fever around that the Gujarati new year, Bestu Varas, which fell on the next day of Diwali, November 1, has still not fully subsided, with noise of crackers still heard in the urban area where I live, what appears strange to me how on the eve of every Diwali is how superstitions take round among believers. One of these I noticed is, people cook some bit of food on a day before Diwali, which is called Kali Chaudas, and place it on the crossroads.
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