Electronic Nicotine Delivery Systems, as the name suggests, are battery-operated, handheld devices that are alternatives to traditional smoking of cigarettes. They provide nicotine via the respiratory route, without the associated ill-effects of tobacco.
E-cigarettes, e-hookahs, e-cigars, vaporizers etc are some of the ENDS, and they are emerging as popular alternatives to smoking cigarettes. They are also being increasingly used for other purposes such as inhaling various drugs etc. They may resemble products such as cigarettes or cigars, or they may be shaped liked pens, flashlights etc.
A normal ENDS consists of a battery (rechargeable or single-use disposable), a vapourizer and a heating coil, a mouthpiece, and a cartridge containing liquid nicotine. This liquid is vapourized and inhaled. The liquid also contains flavours, anti-freeze, propylene (or diethylene) glycol, and carcinogens such as nitrosamines.
ENDS industry is poised to witness a CAGR of 63% in the five-year span from 2013-18. However, it remains unregulated. Unregulated sale of e-cigarettes in India is dangerous as:
- There is no standardization of dosages of nicotine as well as various additives in the solution.
Carcinogens such as nitrosamines pose health hazards to the consumer.
2. E-cigarettes are falsely marketed as “harmless” alternatives to smoking when they are actually harmful, even though to a lesser extent than normal cigarettes. Also, their unregulated use in places where smoking is prohibited (public places, hospitals etc) may lead to adverse effects to the surrounding population, akin to passive smoking.
3. E-cigarettes do not come under the ambit of COTPA, which exempts the producers from complying with norms such as mandatory pictorial warnings.
4. There is no ban on sale of e-cigarettes to minors, since they are not tobacco products and not covered under any other act. Anyone can order e-cigarettes from online marketplaces.
5. Children may get addicted to e-cigarettes due to the flavour and the fancy for smoke.
6. There have been incidences of accidental ingestion of the liquid, which has proved fatal. Also, there is a risk of explosion with the battery operated devices. Proper regulations and quality checks are needed to prevent such incidents.
7. The sellers are not mandated to display that the e-cigarettes should only be used by people with a history of smoking. As a result, non-smokers may inadvertently try them and this may prove a gateway to actual smoking for people.
8. There is a lack of proper ecosystem such as awareness programmes, rehabilitation centres etc which can support a tobacco addict during de-addiction. In this situation, only e-cigarettes as methods for de-addiction will not bear much fruit.
9. The recent Global Adult Tobacco Survey has shown that pictorial warnings have led to reduction in number of smokers. In this context, regulating ENDS to ensure that they are used only to de-addict present smokers is imperative.
Way forward:
- There is a need to either amend the COTPA to include ENDS, or bring in a new legislation for such devices. Standards and regulations should be set through this legislation.
2. Single policy framework across the country would make compliance simple for all the stakeholders, including consumers and the manufacturers. At present, different states have different laws for this.
3. Proper scientific studies considering the addiction-deaddiction timescales and nicotine metabolism in Indian population should be done to ensure greater therapeutic effectiveness of e-cigarettes.
4. Sale of e-cigarettes to minors and sale on e-commerce platforms should be prohibited, and these devices should be taxed at the same rate as normal cigarettes.
