E-cigarettes ban in India: ICMR recommends complete ban to prevent nicotine addiction among non-smokers

Apex research body - Indian Council of Medical Research (ICMR) has recommended a "complete" ban on Electronic Nicotine Delivery Systems (ENDS), including e-cigarettes, saying ir use can initiate nicotine diction among n-smokers.

ENDS are devices that heat a solution to create an aerosol, which also frequently contains flavours, usually dissolved into propylene glycol and glycerin. 

re are various s of ENDS devices like e-cigarettes, heat-t-burn devices, vape, e-sheesha, e-nicotine flavoured hookah among ors. 

most common is an e-cigarette that produces an aerosolised mixture of flavoured liquids and nicotine, which is inhaled by user. 

In a white paper released on Friday on World Tobacco Day, ICMR said e-cigarettes versely affects cardiovascular system, impairs respiratory immune cell function and airways in a way similar to cigarette smoking and is responsible for severe respiratory disease.

It also poses risk to foetal, infant and child brain development, white paper claimed.

release of white paper comes amid a raging debate over harm reduction aspects of ENDS with some organisations claiming that y help in smoking cessation and are less harmful alternatives to tritional cigarettes. 

Indian government is, however, seeking to ban m stating that y pose health risks to users, that are similar to those of tritional cigarettes.

ICMR officials and scientists, who have studied over 250 research papers on nicotine delivery devices to create an official stance for India, stated that e-cigarettes are also harmful to n-users and have verse health impacts even when people are exposed to second-hand vapours. 

"Passive exposure to vapours during pregnancy can severely affect health of both mor and foetus. re are reports of poisoning due to accidental swallowing by children. se devices also can cause fire and explosion.

"Use of ENDS or e-cigarettes by n-smokers can le to nicotine diction and regular smoking," white paper stated.

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Referring to studies, white paper stated that youths using ENDS or e-cigarettes are more likely to use regular cigarettes later as it increases likelihood to experiment with regular tobacco products and increases intention to indulge in cigarette smoking.

y also increase risk of dual-use due to lack of awareness about harmful effects of ENDS, it said.

white paper highlighted that re is very limited evidence regarding impact of ENDS on tobacco smoking cessation, reduction in cigarette use or verse health effects.

ENDS are vertised through various forms of media with youth being target group and are being marketed as safer alternatives to conventional cigarettes or harm reduction products, in a glamorous manner, so as to make m attractive under guise of being less harmful.

se techniques are aimed at targeting youth and children," it said.

"It is also teworthy that major tobacco companies have purchased or developed ENDS products, with dual commercial intent of expanding ir range of tobacco products while touting ir ability to offer a product that y claim reduces harm from cigarettes.

"Cigarette smokers who may have orwise given up habit are reby retained as nicotine-dicted customers, while those who may have never attempted to experiment with cigarettes are drawn into nicotine diction web. This duality of product marketing is a business strategy opted by tobacco companies who see conventional cigarette smoking diminishing in many countries," white paper claimed.

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sale of e-cigarettes is completely banned in 25 countries, including Brazil, rway and Singapore, while market authorization is required in 17 or countries. 

In United States, ENDS, that are marketed for rapeutic purposes are currently regulated by US-FDA and Center for Drug Evaluation and Research, white paper stated.

Professor K Srinath Reddy, President, Public Health Foundation of India and a rewned cardiologist who chaired ICMR expert group for this white paper said that tobacco consumption, especially cigarette smoking, has shown a decline in India in recent years, in response to several tobacco control measures that have alrey been initiated. 

"Thus, at this juncture, marketing of a product like ENDS or e-cigarettes, with unproven benefit and high potential harm from diction and health risks, is unwarranted as a tobacco control measure,"

Professor Balram Bhargava, Director General of ICMR said, "Given extent of harmful health effects of e-cigarettes to users as well as passive exposure and multiple faces of ENDS use epidemic around world where it was introduced, if appropriate interventions are taken at right time by bringing toger all stakeholders under one umbrella to prevent se impending epidemics of e-cigarettes use, it can le to a public health disaster in India."

In August last year, Union Health Ministry issued an visory to all states and UTs to stop manufacture, sale and import of ENDS.

visory was subsequently challenged in Delhi High Court which ruled it to be n-binding on states and government bodies.

However, some states in India including Punjab, Karnataka, Kerala, Bihar, Uttar Presh, Himachal Presh, Tamil Nu, Maharashtra, Jharkhand, Rajasthan and Mizoram have alrey banned use and sale of e-cigarettes, Vape and E-Hookah.