“Giving up smoking is the easiest thing in the world. I know because I’ve done it thousands of times.” – Mark Twain

Smoking of tobacco poses a serious health threat on both smokers and non-smokers. There has been accumulating evidence demonstrating that smoking causes several diseases, including those affecting the cardiovascular system. In India alone, every third adult consumes tobacco. Among these bidis are the most commonly consumed. They alone contributed to 5.8 lakh deaths in 2011 in India. Although tobacco consumption is habitual and giving up is often not easy for its users, industries launched alternative known as electronic cigarettes (e-cigarettes) claiming to be a healthier alternative to tobacco smoking.

The number of e-cigarette smokers has significantly increased because of the perception that they are a healthy substitute to tobacco consumption with minimal or no harm. However, there is increasing evidence that e-cigarettes emit considerable levels of toxicants, such as nicotine. Apart from the direct harm, it also has a health impact on non-users either through passive exposure. The vulnerable population exposed such as children, aged people, pregnant women are also affected. It can have long-term side-effects which include insomnia, anxiety, an intensified exposure to hypertension, and other complications like cardiovascular disease, complications in pregnancy and low sperm count.

As per a statement by Dr Pankaj Chaturvedi, head and neck oncologist at Tata Memorial Hospital, Mumbai the device has encouraged more people to start smoking because it’s marketed as a product with no harmful effects. Overdosing on e-cigarettes can even be fatal. The minimum lethal dose of nicotine is 30-60 mg; an e-cigarette vial contains about 10 mg of nicotine. If 30 mg of nicotine is consumed in one go, it can be fatal.

Although few companies in India manufacture EON vaping devices, India does not regulate e-cigarette sales. Followed by an advisory from the ministry of health and family welfare issued in 2018, states like Punjab, Bihar, Chattisgarh, Maharashtra, Karnataka and Kerala have banned e-cigarettes. Even then the product continues to be imported, distributed, marketed and sold without a licence or registration.

India should follow the footsteps of countries like the United Kingdom, Europe and Canada where the use of e-cigarettes are restricted and regulated but not banned completely. The device is accepted as a harm reduction tool that helps people to quit smoking tobacco. States within their capacity should consider establishing rules, regulations and guidelines for the manufacture, sale, use of e-cigarettes. They must also enforce a minimum age for sale,   regulate the nicotine content and use of other chemicals. Eg- England allows only 2 mg nicotine content in the refill packs. Also, there has to have a balance between potential risks and opportunities for innovative products that can help smokers get rid of this habit.

With proposed approaches, India will surely be able to minimize the impact of electronic cigarettes among smokers and non-smokers in the future. All we need is collaboration among state regulators and awareness among people.