Union Health Minister Dr Harsh Vardhan has reiterated support for the government ban on electronic nicotine delivery systems (ENDS) such as e-cigarettes, arguing in favour of the measure for the benefit of public health.
“ENDS have a net negative impact on public health,” the Minister said during a recent interview, citing statistics which indicate that 0.02 percent of the country’s adult population use the products whilst 270 million use tobacco, including 53 million who smoke cigarettes. “There is no conclusive evidence to suggest that e-cigarettes are safer or less harmful than conventional cigarettes. On the other hand, there is ample evidence of harm due to use of e-cigarettes, both on personal and public health.”
The Minister pointed to “the current crisis of severe lung disease due to vaping in USA as reported by the Centre for Disease Control (CDC), Atlanta, wherein there have been more than 800 cases of lung sickness and 12 deaths in 2019 alone.” This, Vardhan said, “confirms that use of e-cigarettes can severely impact health,”
Exposure to ENDS, Vardhan said, “would have seriously undermined our tobacco control efforts” had the ban not been undertaken and firms such as Juul and Philip Morris International been permitted to introduce ENDS into India. This, Vardhan said, would have the effect “to not only sustain nicotine dependence among current smokers in the name of harm reduction but also to target new customers by creating the perception that e-cigarettes are ‘safe’”.
Terming them “gateway products”, Vardhan said that use of ENDS “only prolongs their [tobacco users’] nicotine dependence and deprives them a chance of an addiction-free life. Moreover, it is likely to revive the declining smoking rates by luring former smokers to re-initiate nicotine dependence.”
Vardhan refuted the idea that the ban was undertaken out of deference to the tobacco industry in India, which is a significant generator of jobs and tax revenue in the country. When the ban was announced, major tobacco firms’ stocks saw a rise in their value. However, Vardhan asserted that the notion that the ban was enacted to serve their interests “is simply not true.”
As to the efficacy of the ban, Vardhan expressed optimism. “The success of ban depends upon the size of [the] consumer base,” Vardhan said. “[The] larger the size, lesser is the success rate of a ban. In India, he claimed, “e-cigarettes have a small consumer base.” As such, “bans will be highly effective.”
India is one of a number of countries to have enacted tighter restrictions and prohibitive policies on e-cigarettes. The Centre has been aiming to ban the devices since August last year, when the Union Health Ministry directed state governments – a number of whom had already banned ENDS – to do so. Several followed suit before the announcement by Union Finance Minister Nirmala Sitharaman that an ordinance had been approved by the Union Cabinet banning the sale, distribution, production, importation, and advertisement of ENDS in the country. Penalties were imposed prescribing jail time and fines for violators of the ban, even for possession of the devices.
While the ban received praise by many observers at home and abroad, including the World Health Organization and Prime Minister Narendra Modi, it has also faced criticism from the e-cigarette industry and from some public health experts. They have argued that ENDS can benefit public health by helping people to quit smoking and disputing claims that they are as harmful or more so than conventional methods of tobacco use.
Two legal challenges were filed against the ban by e-cigarette companies in the Calcutta High Court within a week of its announcement. “We are confident of defending our decision,” a Union Health Ministry official said in response to the challenge.