This refers to the editorial, ‘Vapourised’ (IE, September 20). It states that the “ban on e-cigarettes is symptom of a larger malaise — governing by the brute force of a hammer when the subtlety of a scalpel is required”. We disagree. The ban is targeted at removing a cancer that was threatening the life of unsuspecting users.
Smoking-related diseases rank among the greatest public health problems of the last century. Smoking, it is feared, will kill around a sixth of the world’s population in the 21st century. However, it is not enough to see smoking as just another bad habit. Commerce, social factors and the absence of state regulations play important roles in people getting hooked to tobacco. However, there are positive signs. As per the second Global Adult Tobacco Survey 2016, India has seen the steepest decline in tobacco consumption (17 per cent) in any part of the world. There could be several reasons for this, but certainly not because e-cigarettes, “offer a path to quitting” to older smokers.
E-cigarette is a nicotine containing device that is owned or promoted by the cigarette industry. The basis of e-cigarette promotion was its safety vis-a-vis conventional cigarettes. E-cigarettes are claimed to contain nicotine minus the carcinogens in traditional cigarettes. However, nicotine is even more addictive than cocaine. Currently, there is no treatment for nicotine addiction. Moreover, nicotine even in its pure form is potentially carcinogenic. A dose of 30-50 mg of nicotine can kill an adult human.
Needless to say, tobacco is the cheapest source of nicotine. Therefore, pure nicotine is a myth and not a reality. The government of India is working towards the reduction of tobacco cultivation. The use of e-cigarettes stood in the way of this endeavour.
The wolf in the sheep clothing now stands exposed. The US has been rocked by vaping related cases of severe lung sickness. There have been 21 deaths in the past three months. The use of tobacco should be seen as a historical mistake. We now have opportunity to correct this mistake and protect next generation from the killer tobacco industry.
The editorial notes that like conventional cigarettes, “the use of e-cigarrettes should be regulated”. However, we feel its better to nip the problem in the bud. The editorial also talks of the rise in the share prices of ITC following the e-cigarette ban. This is inconsequential because cigarette use is declining steadily in India. Globally, the cigarette business is no more lucrative. And, in fact, e-cigarette seems to be the tobacco industry’s biggest hope.
Till date, there is no conclusive evidence that e- cigarettes prove beneficial in quitting cigarettes. On the contrary, it is known that among those who use e-cigarettes to stop smoking, 25 per cent use along it with cigarette and 75 per cent continue to use it even after quitting smoking.
As a thumb rule, nearly 10 per cent of smokers quit through the dint of will power. Approved drugs (nicotine tablets), under medical supervision, double this quitting rate. An e-cigarette, even if it’s proved to help people quit smoking, is a far more expensive proposition compared to medically-approved methods. Fears that the end users will not be conventional cigarette users but youngsters who are the prime targets of the e- cigarette industry are not unfounded.
We agree with the editorial that prohibition does not work. But that is true for cigarettes that have a huge consumer base. Since e-cigarettes have a small consumer base, a ban is likely to be effective. India does not manufacture e- cigarettes; so, the country will not suffer revenue losses. We do not agree with the editor’s opinion that the government should make efforts to connect with “all stakeholders of e-cigarettes”. The prime beneficiary of the e-cigarette business is the tobacco industry and its supply chain. The industry that is responsible for the death of more than 13 lakh Indians every year should not be engaged in such a discussion.
The country is struggling to control multiple addictions — tobacco, pan masala, alcohol, cannabis — among the youth. The government’s decision to ban e-cigarettes is the way forward towards an addiction-free society.
This article first appeared in the October 10, 2019 print edition under the title ‘Nipping it in the bud’. Chaturvedi is deputy director, Center for Cancer Epidemiology, Tata Memorial Center, Mumbai and Singhavi is a Mumbai-based surgeon.