India moved to ban e-cigarettes as these new products were undermining tobacco control efforts, and the new forms of nicotine addiction would have only raised the economic burden on the country. The pre-emptive move was also necessary because Juul, the largest e-cigarette brand, was planning to launch its products in the country by the end of December, 2019.
"e-cigarettes also harm non-smokers. Being gateway products, they pose a huge risk of initiation of nicotine addiction among non-smokers, adolescent, youth and even children. "There is also evidence to suggest serious adverse health effects of vaping even without nicotine. Proliferation of these new products can severely undermine our tobacco control efforts," Harsh Vardhan, Union Minister for Health and Family Welfare, told IANS.
The government took the ordinance route to ban electronic cigarettes so that their usage didn't acquire epidemic proportions, especially among the children, adolescent and youth. The National Health Policy targets 15 per cent reduction in prevalence of tobacco use by 2020. These new products not only severely undermine tobacco control efforts, but can also adversely impact the economy, said Health Ministry officials.
India's total economic costs in 2011 attributed to tobacco use -- including that of all diseases among persons aged 35-69 years -- amounted to Rs 1.04 lakh crore. This estimated cost was 1.16 per cent of the GDP and 12 per cent more than the combined state and Central government expenditures on health in 2011-12.
With new forms of nicotine addiction hitting the market, the economic burden is only likely to increase, officials said. The Indian Council of Medical Research (ICMR) recommended a complete ban on e-cigarettes and other Electronic Nicotine Delivery Systems (ENDS) in May this year.
The government received several representations from reputed medical practitioners, institutions and hospitals, who favoured a complete ban on such items. These include Indian Medical Association, AIIMS, Jodhpur, Tata Memorial Hospital, Mumbai, Devi Shetty, Narayan Hrudayalaya, Rajiv Gandhi Cancer Institute, Delhi, and the Association of Oral and Maxillofacial Surgeons.
A representation endorsed by 1,061 doctors from all over India also sought a comprehensive ban on e-cigarettes. All the three sub-groups constituted by the Health Ministry concluded that though e-cigarettes were marketed as safer alternatives to conventional cigarettes, there is no conclusive evidence to support such claims. Safety of their flavours in combination with nicotine and other psychoactive substances is also not known.
The Health Ministry issued an advisory on August 28 last year to the governments of all the states and Union Territories in response to a PIL filed in the Delhi High Court. The trend of a rapid increase in the use of e-cigarettes and like devices by the youth and children in countries where they were introduced is clear.
According to the World Health Organisation's (WHO) report on Global Tobacco Epidemic (2017), 30 countries including include Mauritius, Singapore, Korea, Sri Lanka, Thailand, Brazil, Mexico, Uruguay, Bahrain, Iran, Saudi Arabia and United Arab Emirates have banned e-cigarettes.
There have also been recent advisories in the US on e-cigarettes. San Francisco became the first US city to ban the sale of e-cigarettes in January this year.
In August, the New York Health Department issued an advisory to inform about an emerging health threat of severe pulmonary disease associated with the use of vape products.
