Context

The government’s proposal to ban e-cigarettes and other electronic nicotine delivery systems (ENDS).

About

About

• An electronic cigarette or e-cigarette is a handheld battery-powered vaporizer that simulates smoking by providing some of the behavioural aspects of smoking, but without burning tobacco.
• E-cigarettes contain potentially harmful substances – such as heavy metals like lead, volatile organic compounds and cancer-causing agents.
• e-cigarettes contain nicotine and not tobacco, they do not fall within the ambit of the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA), which mandates stringent health warnings on the packaging and advertisements of tobacco products.

Facts on e-cigarettes

• E-cigarettes aim to resemble cigarettes, but without burning tobacco.
• They are sold as aids to reduce or quit smoking, and some people find them helpful for this.
• However, research shows that they may have a negative impact on health.
• Health authorities are trying to tighten up regulations to discourage young people from using e-cigarettes.

 Benefits

• E-cigarettes claim to bypass many of the health risks of tobacco smoking, and to offer a more healthful alternative to cigarettes and other conventional forms of nicotine intake.
• Some studies have found that using e-cigarettes can help some smokers quit.
• They offer "modest" benefits for those who want to quit smoking, but "good potential" for those who are cutting down.
• The Centers for Disease Control and Prevention (CDC) says that e-cigarettes can benefit adult smokers who are not pregnant, as long as they completely replace any other nicotine or tobacco products.

Risks

• Most e-cigarettes contain nicotine, which is addictive and triggers changes in the adolescent brain. It is hazardous during pregnancy as it can affect fetal development.
• The aerosol contains solvents, flavorings, and toxicants, which the Surgeon General describes as either "harmful" or "potentially harmful."
• E-cigarettes expose the lungs to different substances. One of these is dicetyl, which can cause "popcorn lung," a severe and irreversible lung disease.
• Potentially fatal poisoning has resulted from accidentally swallowing and from inhaling c-cigarette liquid.
• People who seek to quit smoking will stop using conventional and medically monitored methods of doing so.
• Those who use or who have used e-cigarettes are less likely to stop smoking altogether.
• Teens who use e-cigarette products are more likely to start using regular tobacco as well.
• Continued use of nicotine can make other drugs, such as cocaine, more pleasurable.
• The flavorings, the marketing, and the concept that it is not harmful all tempt teenagers to start vaping. There is concern that this increases the chance that they will smoke conventional cigarettes later.
• Second-hand smoking is not eliminated by vaping, as vaping releases carcinogenic emissions.

 How do e-cigarettes affect the brain?

• The nicotine in e-liquids is readily absorbed from the lungs into the bloodstream when a person uses an e-cigarette.
• Upon entering the blood, nicotine stimulates the adrenal glands to release the hormone epinephrine (adrenaline).
• Epinephrine stimulates the central nervous system and increases blood pressure, breathing, and heart rate.
• As with most addictive substances, nicotine activates the brain’s reward circuits and also increases levels of a chemical messenger in the brain called dopamine, which reinforces rewarding behaviors.
• Pleasure caused by nicotine’s interaction with the reward circuit motivates some people to use nicotine again and again, despite risks to their health and well-being.

Steps to be taken

• There are more than 460 different e-cigarette brands with varying configurations of nicotine delivery available in the market.
• The ICMR has recommended complete prohibition on ENDS or e-cigarettes in India in the greater interest of protecting public health.
• By bringing together all stakeholders under one umbrella to prevent this impending epidemic of e-cigarettes use.
• Advertising has been shown to promote a positive brand image for vaping devices and to spur youth to try them, while social media marketing has been linked to explosive growth in sales. Therefore, governments globally should promptly ban all e-cigarette advertising.
• Governments should also mandate plain packaging for vaping devices, ban their use wherever tobacco use is banned and strictly limit the accessibility of sales to youth – placing e-cigarettes behind the pharmacy counter.