Futile Ban: E-Cigarettes Do Not Pose Major Health Risk To Users, Cigarettes Do

In what has so far been a relatively open market, Electronic Nicotine Delivery Systems or e-cigarettes seem to have been curiously singled out by the government for stringent action. The government’s ire against the category is so strong that it has proposed an emergency measure like an ordinance to keep ENDS out of the Indian market.

Attempts by the government to restrict e-cigarettes have been questioned by many, including several courts and public health experts. At each step, the Ministry’s approach has meandered and they seem to be willing to do whatever it takes to accomplish their singular goal of banning them without doing a fair evaluation. But even before we question whether the end justifies the means, what needs to be asked is if the end in itself is justified.

Reputed global research institutions have held that e-cigarettes are at least 95 per cent less harmful than traditional cigarettes, and some, including the American Cancer Society, have even recommended encouraging smokers to switch to the less harmful alternative available, stating that, “switching to exclusive e-cigarettes is preferable to continuing smoking combustible tobacco products”.

Disregarding all evidence showcasing the potential of e-cigarettes as a tool to reduce the country’s tobacco burden, the Ministry of Health and Family Welfare (MoHFW) has carefully and willfully proceeded with the move on faulty scientific logic.

This single-minded resolve is without the due process of consultation, a dispassionate assessment of costs and benefits or any independent India-based scientific study. The first blow came in the form of an advisory to states by the ministry to ban e-cigarettes and similar products in August 2018. It was diffused when the Delhi High Court held it non-binding in November 2018.

Next, was a Customs department circular which ordered all ENDS import shipments to be referred to state drug controllers to check for compliance. This was quickly followed by a letter to State Drug Controllers by the Central Drugs Standards Control Organization (CDSCO) asking them to disallow manufacture, sale, import and advertisement of ENDS in their jurisdiction.

This move too faced legal hurdles when the Delhi High Court held that since ENDS weren’t “drugs”, they could not be regulated under the Drugs and Cosmetics Act, and so the CDSCO had no authority to issue this letter or check import consignments. Both circulars were stayed by the Court and further hearings on the matter have not led the court to reverse or alter its decision.

The fact that every single one of the Ministry’s moves so far has failed to be held up in court seems to have done little to change their mind to take a progressive and inclusive approach to regulate the category keeping in mind the demographics and local issues that will need to be addressed.

Instead, with a renewed vigour that seems incomprehensible, the government included its plans to ban ENDS in its 100-day agenda. In the absence of an appropriate legal recourse, the government has now introduced an ordinance to ban ENDS, disregarding medical and scientific evidence.

The ministry’s point of view has been that allowing e-cigarettes into the market could open a pandora’s box. E-cigarettes are sophisticated devices that command a price premium which can be afforded by a very small number of people in India, as opposed to cigarettes that are sold as single sticks and easily accessible to a large population including vulnerable groups.

By its own admission, in response to a Parliament question, the government stated that it believes less than .02% people in India are aware of or use ENDS or e-cigarettes as opposed to 267 million tobacco users in the country. Yet, the push and the rigour with which the Government is keen to ban e-cigarettes is not even remotely comparable to trade in cigarettes.

It is ironic that in a country of 106 million smokers, the question of banning cigarettes or bidis has never been seriously considered, and yet, e-cigarettes, which have been proven to be a less harmful alternative conveniently becomes part of the first 100 days agenda and are being banned through an ordinance.

Anti-tobacco organisations must ask if the government is planning to bring a time-bound banning order against cigarette sales anytime soon?

As the voice of the ENDS trade community, we must question both the government’s priorities and methods. Non-communicable diseases like cancer, cardiovascular disease and respiratory illnesses today comprise over 60 per cent of the overall disease burden in the country.

Yet, instead of adopting every tool at their disposal to reduce this burden, the government seems to be going out of its way to prevent the entry of one such tool. As per latest reports, one billion fewer cigarettes were smoked in England between 2011 and 2018, the period that saw the popularity of e-cigarettes grow. Such a dramatic decline in cigarette use would translate directly into millions of life-years saved.

India is undergoing a transformation in almost every aspect, including public health. At such a juncture, it seems unwise, and even unreasonable, that the government would actively block technology and innovative tools that have proven to be successful in other countries.

(The author is the Convener of Trade Representatives of Electronic Nicotine Delivery Systems. Views expressed are personal)