What are E-Cigarettes or Vapour Smoke and what are the health hazards of E-Cigarettes?

What are E-Cigarettes?   

Electronic cigarette (E-cigarette, e-cig) is a battery-powered vaporizer which simulates the feeling of smoking, but without burning tobacco. Using an e-cigarette is called vapour smoke or vaping. The user puffs on the mouthpiece of a cartridge. This causes a vaporizer to heat the liquid inside the cartridge. This liquid contains nicotine, flavorings, and other chemicals. The heated liquid turns into the vapor (aerosol) that is inhaled. These e-cigarettes are also called electronic nicotine delivery systems (ENDS).

 Types of E-Cigarettes

There are different types of e-cigarettes available. The primary types are disposable and reusable e-cigarettes. Disposable e-cigarettes look like traditional cigarettes, and contain liquid, battery and heating device. Reusable e-cigarettes also consist of similar elements, except that the battery is rechargeable and liquid can be refilled. 

Most e-cigarette consumers use re-usable e-cigarettes. They buy the device (usually costing anywhere between Rs. 1500 to 10,000) and purchase the liquid separately on a regular basis.

Health Hazards of E Cigarettes

The flavors in e-cigarettes are one of the main reasons youth uses them, e-cigarette aerosol is not safe and that e-cigarette use is strongly associated with the use of other tobacco products among youth and young adults.

Youngsters are being lured towards e-cigarettes by projecting them to be a “healthier” alternative to traditional cigarettes but this is not true. Though e-cigarettes don’t contain tobacco they are still harmful as people still get addicted to nicotine present in e-cigarettes which has harmful consequences in the long term. Nicotine is well known to have serious systemic side effects in addition to being highly addictive. It adversely affects the heart, reproductive system, lung, kidney etc. Many studies have consistently demonstrated its carcinogenic potential. According to some studies the use of e-cigarettes may cause DNA mutation, cancer, heart disease and asthma.

Consumer Voice along with its state partners has submitted a memorandum to the respective Chief Ministers, Health Minsters and Health Secretary.

On 14th June,2018 the Health Minister of Tamil Nadu Mr. C Vijaya Baskar announced in the legislative assembly that the state government is going to completely ban e-cigarette in Tamil Nadu keeping in mind their impact on the health of citizens.  In India e-cigarette is currently banned in 8 states which are Jammu & Kashmir, Karnataka, Punjab, Maharashtra, Bihar, Mizoram, Uttar Pradesh and Kerala.

Our state partners have written to important stakeholders in the states of Himachal Pradesh, West Bengal, Bihar, Tripura, Maharashtra etc for banning e-cigarettes and media supported the initiative.

Also Read:

Ban E-Cigarettes to Secure Future

E-Cigarettes are being promoted as a heather alternative to cigarettes or bidis. Changing the mechanism of inhaling nicotine does not change the health hazards that an e-cigarette  poses.  It is as harmful as any other tobacco product. However there are no requisite provisions to ban it under the Cigarettes and Other Tobacco Products Act (COTPA).

 In India, there are a number of online retailers who sell e-cigarette devices, accessories and liquids. These are purchased online without any restriction, including in states where e-cigarettes are banned. The offline market seems to be less evolved, and these products are not easily available in traditional stores selling tobacco products.

 

Severity of inclusion of E-Cigarettes in Important Drugs and Tobacco Laws in India

  • The Drugs and Cosmetics Act, 1940 does not provide any clear classification on usage of nicotine especially in regards to e-cigarettes. Nicotine gums or lozenges are regulated under Chapter IV of the Act. Currently, there is no central legislation concerning e-cigarettes.

 

  • Nicotine gum (2 mg and 4 mg) and lozenges are regulated under Chapter IV of the Drugs and Cosmetics Act. Rule 122 (E) of the Act states that any change in the form of the same substance will establish it as a new drug. That makes liquid nicotine, which is used in e-cigarettes, technically a new drug, requiring Drugs Controller General of India approval before it can be launched in Indian markets. The product continues to be imported, distributed, marketed and sold without license or registration.

 

  • As per rule 122 E of the Drugs and Cosmetics Act 1940 and Rule 1945, every new drug should be sold in the country with the prior approval of Drugs Controller General of India. Permission to sell lozenges or gums containing less than 2mg nicotine are already given by Drugs Controller General of India. However, nicotine products above 2 mg are supposed to be sold only when prescribed by a registered medical practitioner.

 

  • E-cigarette vial contains about 10 mg of nicotine. At sufficiently high doses, nicotine is associated with poisonings and is potentially lethal.

 

  • Nicotine has been declared as a lethal and hazardous substance under the Environment (Protection) Act and Insecticide Act. It’s only permitted use for human consumption is up to the level of 2 mg in the form of chewing gum or lozenges under the Drugs and Cosmetics Act.

 

  • Since the e-cigarettes are being sold in the market without permission, this is in contravention of sections 18(b) and 18(c) of Drugs and Cosmetics Act.

 

  • Importing, manufacturing and selling and distributing of drugs without permission from DCGI and without license from the department is illegal and may attract imprisonment of 3 to 5 years.

 

  • Cigarettes and Other Tobacco Products (prohibition of Advertisement and Regulation of Trade and Commerce, Production, supply and Distribution) Amendment Bill, 2015 was withdrawn and a new Bill will be introduced by incorporating provisions to counter illicit trade in tobacco product and to effectively address emerging threats such as ENDS (Electronic Nicotine Delivery System).

 

Efforts by State Governments and NGOs like Consumer VOICE to ban E-Cigarette

 The states of Karnataka, Uttar Pradesh, Haryana, Kerala, Punjab, Jammu and Kashmir, Mizoram, Bihar and Maharashtra & Chandigarh (UT) have banned e-cigarettes under the Drugs and Cosmetics Act, 1940, and Food Safety & Standards (Prohibition and Restriction on Sales) Regulation, 2011. Selling e-cigarettes has attracted a conviction in Punjab, Maharashtra.

The Union government is likely to ban e-cigarettes following an expert committee’s conclusion that they have cancer-causing properties, are highly addictive and do not offer a safer alternative to tobacco-based smoking products. There are no requisite provisions to ban it under the Cigarettes and Other Tobacco Products Act (COTPA).

Consumer VOICE along with its state partners is working towards the Tobacco Intervention throughput India. Through joint efforts with our Tamil Nadu partner in Chennai we were able to sensitize relevant government officials towards ban on e-cigarettes. We both put continuous efforts to convince important stakeholders on the harms caused and how banning will help in the cause of individual and public health. As per the latest news, ban on e-cigarette has been announced by Health Minister Shri C. Vijayabaskar in the state of Tamil Nadu. We have approached Delhi Government similarly for this ban and they are also thinking on the same line.

Our state partners have written to important stakeholders in the states of Himachal Pradesh, West Bengal, Bihar, Tripura, Maharashtra etc for banning e-cigarettes and media supported the initiative.

Also Read:

Tobacco Breaks Hearts

Tobacco Breaks Hearts

Tobacco smoking is harmful and causes cancer. But did you know that smoking isa major cause of cardiovascular disease (CVD) too. CVD causes one of every three deaths, according to the 2014 Surgeon General’s Report on smoking and health. Recognising this warning, WHO will be focusing on the impact of tobacco on cardiovascular health this World No Tobacco Day which will be observed on 31st May, 2018.

In India, every year, more than 9 lakh people are killed because of tobacco causing diseases. Yet, in India, more than 6 lakh children (10-14 years old) and almost 100,000,000 adults (15+ years old) continue to use tobacco each day.  (Source: tobacco atlas)

Tobacco Use in India

  • 19.0% of men, 2.0% of women and 10.7% (99.5 million) of all adults currently smoke tobacco.
  • 29.6% of men, 12.8% of women and 21.4% (199.4 million) of all adults currently use smokeless tobacco.
  • 42.4% of men, 14.2% of women and 28.6% (266.8 million) of all adults currently use tobacco (smoked and/or smokeless tobacco).

Source: GATS

Many call themselves a non-frequent smoker. But even if you smoke less than 5 cigarettes, early signs of CVD can set in. Even if you are smoking cigarettes with lower levels of tar or nicotine it does not reduce the risk for cardiovascular disease.  Smokeless tobacco is no less harmful. In India, 171094600 people still currently use smokeless tobacco, indicating an ongoing public health challenge.

Smoking Damages your Heart

Atherosclerosis

Any amount of smoking, even light smoking or occasional smoking can bring about serious damage to the heart and blood vessels. For some people, such as women who use birth control pills and people who have diabetes, smoking poses an even greater risk to the heart and blood vessels. Atherosclerosis is caused when the opening inside the arteries narrows as plaque builds up, and blood can no longer flow properly to various parts of the body. Smoking increases the formation of plaque in blood vessels.

Stroke

Smokers are at a greater risk of strokes than among former smokers or people who have never smoked. The carbon monoxide in tobacco smoke reduces the amount of oxygen in your blood. This means your heart must pump harder to supply the body with the oxygen it needs.

Peripheral artery disease (P.A.D.)

Smoking also is a major risk factor for peripheral artery disease (P.A.D.). In this condition, plaque builds up in the arteries that carry blood to the head, organs, and limbs. This results in an increased risk for heart disease leading to heart attack, and stroke.

When combined with other risk factors—such as unhealthy blood cholesterol levels, high blood pressure, and overweight or obesity—smoking further raises the risk of heart disease.

Second Hand Smoking is equally harmful

Research shows that exposure to second hand tobacco smoke is a cause of heart disease in non-smokers, which means you could be harming the health of your children, partner or friends.Secondhand smoke lowers good cholesterol, raises blood pressure and damages heart tissues of non-smokers especially children and teens.

Secondhand Smoke in India

  • 38.7% of adults were exposed to second hand smoke at home.
  • 30.2% of adults who work indoors are exposed to second-hand smoke at their workplace.
  • 7.4% of adults were exposed to second hand smoke at restaurants.

Source: GATS

Quit Now

Smoking damages the heart and blood vessels very quickly, but it can be repaired by quitting. Remarkable health improvements can be seen and within a year, heart attack risk drops dramatically. Within five years, most smokers cut their risk of stroke to nearly that of a non-smoker. Even a few cigarettes now and then damage the heart, so the only way to keep your heart safe from the effects of smoking is to quit.

The good news is 55.4% of current smokers in India are planning or thinking of quitting smoking and 49.6% of current smokeless tobacco users are planning or thinking of quitting smokeless tobacco use.  (Source: GATS)

With World No Tobacco Day being observed on May 31st in India along with the rest of the world, Consumer VOICE along with its state partners hope to create an impact and dissuade people from using tobacco in all forms.

Consumer VOICE and its State Partners Hail the Ministry’s Decision on Pictorial Warning on Cigarette Packs

Consumer VOICE and its State Partners Hail the Ministry’s Decision on Pictorial Warning on Cigarette Packs

The global tobacco epidemic is killing thousands of people worldwide and in India it kills one million Indians every year. There are almost 267 million tobacco users in India. To curb the country’s enormous tobacco epidemic, a series of strong actions have been taken at both the national and state level. Among the various steps taken, one of the most effective one has been that of including large, graphic warning or pictorial warning on cigarette and bidi packs.

Moving in the right direction, the Health Ministry’s decision of replacing the existing images on tobacco products and replacing with a new set of 85 percent pictorial health warnings for mandatory display on both sides of the packets of cigarettes, bidis, and chewing tobacco with effect from September 1, 2018 has been hailed by one and all.

As per the notification, during the rotation period 2 images of specified health warnings as notified in the schedule shall be displayed on all tobacco product packages and each of the images shall appear consecutively on the package with an interregnum period of 12 months.

For smoking and smokeless forms of tobacco products, the word “TOBACCO CAUSES CANCER” and the word “TOBACCO CAUSES PAINFUL DEATH” shall appear in white font colour on a red background. The Ministry also introduced a ‘Quit Today’ a toll free helpline number “1800-11- 2356” which will appear in white font colour on a black background.
 
Pictorial health warning is highly effective in a country like India where literacy rate is not too high. These pictures speak volumes that a simple line Cigarette Smoking is Injurious to Health will do. India’s current international ranking for package warnings is no. 3 rd  in the world, as outlined in the October 2016 Canadian Cancer Society Report, Cigarette Package Health Warning International Status Report that ranked 205 countries worldwide. The entire world applauded this progressive step taken by India in tobacco control and saving human lives. Implementing 85 percent pictorial warnings was a landmark step taken by the Government of India.  Shri J.P. Nadda was awarded by the World Health Organization for this major reform in public health.

Dr.Shekhar Salkar , Head of Department, Oncology, Manipal Hospital Goa and President National Organisation for Tobacco Eradication also reiterated that that the new graphical health warning is much more effective deterrent for younger generation who initiate tobacco use. In a country like India, where people use several languages and dialects, the pictorial warning transcends the language and, in many cases, also the illiteracy barrier.

The recently released Global Adult Tobacco Survey (GATS) 2016-17 by Union Ministry of Health and Family Welfare (MoHFW) had put to rest all apprehensions about the effectiveness of the warnings, since 62% of cigarette smokers and 54% of bidi smokers shared that they had thought of quitting because of the 85 percent pictorial warnings on the packets. And 46% of smokeless tobacco users thought of quitting because of the warnings on smokeless tobacco products says Ashim Sanyal, COO Consumer VOICE.

Consumer VOICE and its state partners applauded this move of the Government which is evident
from the relevant media coverage:

Print Media

State :Punjab and Union Territory :Chandigarh


THE TIMES OF INDIA

DAINIK SAVERA TIMES

JAGMARG

AMAR UJALA

DAINIK BHASKAR

Hindustan Times

PUNJAB KESARI

Himachal Dastak

DNS

Print Coverage

 

Dainik Herald

Dainik Herald

GOAMANTAK

GOAMANTAK TIMES

GOAN Everyday

GOAN VARTHA

Tarun Bharat

Gujarat Samachar

 

Online Coverage

  1. UNI India –Consumer VOICE welcomes 85 % pictorial health warnings on cigarette packets
  2. Times of India: NGO welcomes move
NOTE and Consumer VOICE meet in Goa on tobacco control and role of media

NOTE and Consumer VOICE meet in Goa on tobacco control and role of media

National Organisation for Tobacco Eradication (NOTE) and Consumer VOICE, Delhi organized a press interaction meet on April 6, 2018 at International Centre Goa (ICG), Dona Paula. The purpose of this meet was to discuss various pressing issues related to tobacco use and how media can play an effective role in tobacco control.

Tobacco kills over 7 million people each year, and, if current trends persist, tobacco will cause 1 billion deaths this century, mostly in low- and middle-income countries. Addressing a press conference in Goa, AshimSanyal, COO Consumer Voice  welcomed the decision of the Health Ministry and said that the“Health Ministry has implemented from April 2016, large pictorial health warnings occupying 85 percent on both sides of all tobacco packages of cigarettes, bidis and all forms of chewing products. He also said said that the vendor licensing is an effective way to manage random sale of tobacco products and aims at controlled sales through registered vendors.” Mr Sanyal also hailed the Government’s decision of introducing ‘Quit Today,’ a toll free helpline number to be printed on all tobacco products.

Goa is a real good example of tobacco control achievements through a partnership between Government and civil society organisations. However more needs to be done to eradicate the tobacco menace.

Dr.ShekharSalkar , Head of Department, Oncology, Manipal Hospital Goa and President National Organisation for Tobacco Eradication (NOTE)who is championing the tobacco control initiatives in Goa pointed out several instances of violation of laws and said that the work needs to be amplified to reach to the goa population to encourage them to participate in the process of tobacco control. He also raised concerns about the increase in the number of female smokers in the state.

AshimSanyal also raised the concern of about the youth getting attracted to electronic smoking and heat not-burn tobacco. He also underlined the need for amending the Cigarettes and Other Tobacco Products Act. The Global Adult Tobacco Survey India 2016-17 has revealed that 9.7 per cent of Goa’s population consumes tobacco, 6.5 per cent of which consume smokeless tobacco.

Media has great role to play in saving lives of millions of fellow Indian and to save younger generation from falling into the deadly tobacco trap.

The meet was a successful one and though more efforts are needed, it is a start in the right direction.

 

Media Coverage

Print Coverage

Times of India

Dainik Herald

Dainik Herald

GOA DOOT

GOAMANTAK

GOAMANTAK TIMES

HERALD

GOAN Everyday

GOAN VARTHA

Tarun Bharat

NAVHIND TIMES

Online Media Coverage:

 

Electronic coverage