Why in news?
=>In a directive issued to all States and Union Territories, the Union Ministry of Health and Family Welfare (MoHFW) has stopped 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.
What’s the issue?
=>The move was taken citing the risk posed to children, adolescents and women in the reproductive age. It adds that ENDS has already been banned in 30 countries.
=>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 the belief that they help in tobacco cessation and are safer than cigarettes or other forms of tobacco-consumption as most do not contain tobacco, the source of nicotine and which is one of the most addictive substances.
=>A number of metals, including lead, chromium, and nickel, and chemicals like formaldehyde have been found in aerosols of some ENDS, with concentrations equal to or greater than traditional cigarettes, under normal experimental conditions of use.
Why advisory/directive and not a ban?
=>Since health is a state subject, the Union ministry had to issue an advisory. The ministry’s advisory came a week after Delhi High Court ordered it to take regulatory measures to control the sale of e-cigarettes. It remains to be seen how many states act upon the advisory and issue ban orders.
Misconceptions:
=>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.
=>People believe that the cancer-causing element is absent in the devices and are simply getting the pleasure of smoking. But several studies have found that use of ENDS leads to initiation of smoking.
=>The most ENDS available in India are of Chinese make and non-branded. “However, well-known companies like ITC and Philip Morris International (PMI) have ENDS in the form of an e-cigarette called EON and a heat-not-burn device called iQOS, respectively. With the new advisory, these devices cannot be marketed or sold any more.
ENDS vs. cigarette:
=>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 Rs. 7, a cartridge costs at least Rs. 200.
=>Experts say that when it begins to pinch the pocket, most ENDS users go back to cigarettes. 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.
Nicotine alert
=>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.
=>The 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.
Way Forward:
=>The sale of e-cigarettes was never permitted in India. But since there was no government ruling or notification that says so, the illegal sale was rampant. Now with this advisory, the confusion will go away.
=>This advisory will prove to be a bane for the cigarette manufacturing companies. Much against the common perception, e-cigarettes used to serve as gateway to cigarette smoking.
=>In fact, the largest cigarette manufacturing company of India was one of the largest E-cigarette manufacturing companies as well because such cigarettes give adolescents first exposure to nicotine. And nicotine being the most addictive chemical, the e-cigarette users would take to smoking cigarettes as well.
=>According to globaldata.com, India’s e-cigarette market was poised to grow at a compound annual growth rate of 34 per cent from Rs 4.1 billion in 2017 to Rs 7.4 billion in 2019.
A typical e-cigarette consists of three important parts:
=>The activity called ‘vaping’ allows users to inhale vapours of nicotine akin to the experience of puffing on a real cigarette, but they do not light it, and it produces no smoke. Rather, it produces a fine, heated mist, which is absorbed into the lungs.
How does an e-cigarette work?
=>When the battery is switched on, the cartridge which contains the nicotine is atomised with the help of humedectants such as propylene or glycerol. As the person pulls on the cylinder, he inhales the vapours of nicotine and gets a feeling akin to smoking.
Pic coutersy:medscape.com
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