- The Union Ministry of Health and Family Welfare (MoHFW) has issued a notification regarding Electronic Nicotine Delivery Systems (ENDS).
About the directives
- In the notification, it has directed all States and Union Territories to stop the manufacture, sale, distribution, import, trade and advertisement of Electronic Nicotine Delivery Systems (ENDS) such as e-cigarettes, vaping devices, e-sheesha, e-nicotine-flavoured hookah and heat-not-burn devices, etc.
- The notification highlights the dangers of electronic nicotine delivery (END) systems, citing the risk posed to children, adolescents and women in the reproductive age.
- It highlights that nicotine can have adverse effects on the development of the foetus, may contribute to cardiovascular diseases and could function as a “tumour promoter”.
- Foetal and adolescent nicotine exposure may have long-term consequences for brain development, potentially leading to learning and anxiety disorders.
- It adds that ENDS has already been banned in 30 countries.
About the Electronic Nicotine Delivery Systems (ENDS)
- Electronic Nicotine Delivery Systems (ENDS), also called- e-cigarettes, personal vaporizers, vape pens, e-cigars, e-hookah, or vaping devices- are products that produce an aerosolized mixture containing flavored liquids and nicotine that is inhaled by the user.
- ENDS can resemble traditional tobacco products like cigarettes, cigars, pipes, or common gadgets like flashlights, flash drives, or pens.
- ENDS contain a liquid solution that is usually flavored, which are appealing to children and can include fruit flavors, candy, coffee, piña colada, peppermint, bubble gum, or chocolate.
- ENDS solution has chemicals i.e., anti-freeze, diethylene glycol, and carcinogens like nitrosamines.
- Nicotine gums and patches formulated under a valid drug manufacturing licence (with 2 mg and 4 mg of nicotine content) are the only approved forms of NRT currently.
- Youth use of ENDS products is a significant public health concern.
Significance of the move
- Such devices are often misunderstood as Nicotine Replacement Therapy (NRT) for those who aspire to quit tobacco use, and the Ministry’s notification puts an end to this belief that they help in tobacco cessation and are safer than cigarettes or other forms of tobacco.
- Most ENDS available in India are of Chinese make and non-branded.
- With the new advisory, these devices cannot be marketed or sold any more.
Arguments against ENDS
- A study shows youth who use ENDS products are more likely to use cigarettes or other tobacco products.
- E-liquid from ENDS devices and refill packs can contaminate skin, leading to nicotine poisoning.
- In most ENDS, instead of tobacco, nicotine is used in a chemical form.
- Thus, users of these devices believe that they are not smoking tobacco, but in reality, they continue to have the addictive chemical.
- Several studies have found that use of ENDS leads to initiation of smoking and the dependence on smoking rises with such devices.
- There are some scientific evidences available indicating that ENDS and similar technologies encouraged tobacco use, were hazardous for active as well as passive users, and had an adverse impact on public health.
- A cigarette contains four to six milligrams of nicotine whereas most cartridges used in ENDS contain an equivalent of 10 mg of nicotine, but in liquid form.
- While the cost of a cigarette starts from ₹7, a cartridge costs at least ₹200.
- Experts say that when it begins to pinch the pocket, most ENDS users go back to cigarettes.
- There is no data or literature that supports any positive health outcomes from ENDS.
- Worse, many children are falling prey to its use as they are under the false belief that the absence of tobacco makes it safe.
- Many doctors wrongly advise e-cigarette use to control their patients’ smoking habits too.
- Till date, no health agency has declared it safe for use.
- The biological effects of nicotine are widespread and extend to all systems of the body including cardiovascular, respiratory, renal and reproductive systems.
- Nicotine has also been found to be carcinogenic in several studies.
Arguments in favour of ENDS
- ENDS devices mimic conventional cigarette use and help re-normalize smoking behaviors.
- People believe that the cancer-causing element is absent in the devices and are simply getting the pleasure of smoking.
- The manufacturers believe that the advisory, if implemented, will deprive over 100 million smokers in India access to, and information about, potentially less risky alternatives to cigarettes.
- They argue that smoke-free products are widely regarded as being less harmful than cigarettes and tens of millions of smokers worldwide have already made the switch.
- WHO submitted a report on ENDS to the sixth session of the Conference of the Parties to the WHO Framework Convention on Tobacco Control (COP6) in Moscow, Russian Federation and also in (COP7) in New Delhi.
- The COP welcomed the report and invited Parties to consider applying regulatory measures referred to in the report.
- ENDS are not approved for smoking cessation, and the long-term health effects to users and bystanders are still unknown.
- Hence, there is a need for thorough research about ENDS.