Context: Lok Sabha passed a Bill that seeks prohibition of e-Cigarettes in India calling the ban as a “pre-emptive strike" on the “hazardous" addiction.

About e-Cigarette E-cigarettes are the most common form of Electronic Nicotine Delivery Systems (ENDS). E-cigarettes may be manufactured to look like traditional cigarettes and are marketed as tobacco-free nicotine delivery devices. Instead of burning tobacco leaves like in traditional cigarettes, an e-cigarette, produces aerosol by heating a solution containing nicotine among other things.  The device contains nicotine and flavours in the form of liquid which is primarily composed of solvents such as glycerol and/or propylene glycol.  The aerosol containing a suspension of fine particles and gases simulates cigarette smoke. Following a puff, the aerosol is delivered to the user’s mouth and lungs and the rest is exhaled. E-cigarettes do not contain all of the harmful chemicals associated with smoking tobacco cigarettes, such as carbon monoxide and tar. As per figures submitted to Parliament this year, e-cigarettes and accessories valued at about $1, 91,780 were imported to India between 2016 and 2019. With a smoking population estimated at over 100 million, India is a lucrative market for e-cigarette players.   Tobacco menace in India The country bears 12% of the global burden of tobacco users, has 40% of its adults exposed to passive smoking, and also has the dubious distinction of showing the lowest quit rate among all countries surveyed in the Global Adult Tobacco Survey 2. India is a signatory to the World Health Organization’s Framework Convention on Tobacco Control (FCTC), which calls upon countries to regulate the use of e-cigarettes or ban them altogether.  The Cigarettes and Other Tobacco Products Act, 2003 COTPA Act, regulates the sale, production, and distribution of cigarettes and other tobacco products in India, and prohibits advertisement of cigarettes.

About the Bill

• Replaced the ‘Prohibition of Electronic Cigarettes (production, manufacture, import, export, transport, sale, distribution, storage and advertisement) Ordinance, 2019 : The Prohibition of Electronic Cigarettes Bill, 2019, has been brought in to replace an Ordinance issued on September 18.
• Cognizable offence: The Bill makes manufacturing, production, import/export, distribution, transport, sale, storage or advertisements of e-cigarettes and similar devices a cognizable offense.
• First-time violators can be sentenced for up to one-year imprisonment and fine up to ?1 lakh.
• Subsequent offenses would attract up to three years’ jail term or a maximum fine of ?5 lakh, or both.
• Storage will also be punishable with up to six months in jail or a fine of up to ?50,000, or both.
• The Bill empowers enforcement officials to carry out searches and seize the banned products.

Reasons behind the ban

• Once nicotine is used in the solution of an e-cigarette, the difference between it and a conventional cigarette ends.
• Envisioned as a tool to combat tobacco addiction, electronic cigarettes, and other vaping products have become a major problem and increase the risk of children adopting them.
• Although nicotine itself is not a carcinogen, it may function as a tumor promoter and can also lead to be involved in the biology of malignant disease, as well as neurodegeneration.
• Indian Council of Medical Research in a white paper stated that the uses of ENDS, or e-cigarettes, have documented adverse effects which include DNA damage; carcinogenesis (initiation of cancer formation); cellular, molecular and immunological toxicity; respiratory, cardiovascular and neurological disorders. It also impacts fetal development and pregnancy.
• These products have neither been assessed for safety in the national population nor been approved under the provisions of the Drugs and Cosmetics Act, 1940.
• Nicotine “harms parts of the brain that control attention, learning, mood, and impulse control.
• A 2018 study found the use of e-cigarette daily was associated with a 79% increase in heart attack risk after other variables were taken into account.
• Flavours such as diacetyl used in e-cigarettes are linked to serious lung disease. E-cigarettes also contain volatile organic compounds, heavy metals, such as nickel, tin and lead.
• The U.S. Food and Drug Administration (FDA) has not approved e- cigarettes as an alternative to reduce smoking. One study found that though e-cigarettes led to higher percentage of people quitting smoking, nearly 80% of quitters were still vaping.
• Prior to this announcement, 16 states and one Union territory had already banned e-cigarettes.

Arguments against the ban

• In India, no independent studies have been conducted on the use of e-cigarettes.
• Globally, several tobacco control researchers have concluded that e-cigarettes are at least 95% less hazardous than combustible cigarettes.
• Studies by Public Health England show that the risk of passive smoking associated with them is also extremely low, as they do not produce tobacco fumes.
• There is empirical evidence to suggest that countries, which have regulated ENDS, have witnessed a decline in smoking rates.

According to a study conducted by The British Medical Journal, as many as 68 countries, including the UK, US, Canada, France and Japan, are using a range of regulatory mechanisms aimed at enhancing the discretionary power of their adult citizens.  These include laws that prohibit sales of ENDS to minors, regulate advertising and promotion, impose limits on nicotine concentration, and place checks on product quality and battery standards.

• The World Health Organization and the EU have acted in favour of a regulatory framework instead of a blanket ban. This grants consumers who are unable to quit smoking the right to choose a less harmful alternative.
• E-cigarettes promoting trade bodies, users and other stakeholders opposed the government’s move to ban the “alternative” smoking device through the ordinance route, alleging it to be a “draconian” step taken in haste to protect the conventional cigarette industry.
• Association of Vapers India (AVI), an organization representing e-cigarette users, also alleged that it is a black day for the 11 crore smokers in India who have been deprived of safer options.

Case in other countries

• US: Has the highest population of smokeless tobacco and vape-product users. The use of e-cigarettes, has resulted so far in seven confirmed deaths in the U.S. New York recently banned the sale of flavoured e-cigarettes.
• UK: Sales of ENDS products like vapes are legal. Introduced regulations for e-cigarette firms in 2016.
• France: Allows the sale of e-cigarettes as either medicines or consumer products, but those making health claims related to these products need marketing authorization under the standard drug licensing process.

Way forward

• In view of the challenges involved in implementing tobacco control laws, rampant tobacco industry interference, a large proportion of vulnerable youth population, negligible support available for tobacco cessation, ban on ENDS is a plausible and cost-effective approach subject to effective implementation and monitoring.
• Controlling tobacco use: After the successful banning of e-cigarettes, India should ideally take the bold step of moving to end tobacco use which can be done is a phased manner, safe-guarding the interests of various stakeholders. 
• We need to check the entry of dangerous counterfeits, and deny vulnerable groups access to these products via the black market. 

It is important for the government to examine the data from other countries and formulate a holistic strategy to reduce India’s tobacco disease burden.