India faces heat on vaping laws

NEW DELHI: The Ministry of Health is facing heat following its ban on vaping, even as many countries are reversing such bans and arguing forcefully for the product. Hong Kong, not far from India, is soon going to reverse its ban on the re-export of e-cigarettes and other heated tobacco products by land and sea transport by the end of this year as part of efforts to ignite growth.
“Senior officials are mulling over the relaxation of the trans-shipment ban on re-exporting the alternative smoking products from Hong Kong, given the significant values of the re-export,” a senior government official was quoted. The original intention of the amendment was to prevent the re-exported products from slipping back to Hong Kong through other means.
The new move would roll back the tobacco control regime. Similar changes are happening across Asia, and also Europe. A report last December from the China Electronics Chamber of Commerce found that 95% of the world’s vaping products were produced on the mainland, with more than 90% exported at a value of about $19.23 billion.
And such changes are happening even as the World Health Organization (WHO) continues to wage a war on vaping and other safer nicotine alternatives through campaigns and such initiatives. Vaping is banned in India, it has been three years since the ban came into force following directives issued by the Ministry of Health & Family Welfare.
Vaping involves using a device that vapourises a nicotine-containing liquid the user inhales. Now, it is not without risk, the evidence for vaping does not say that. It merely says cigarette smokers who switch would suffer from far fewer negative effects and live relatively longer, healthier lives.
But research and studies on vaping across the world, mostly in developed nations, are making the governments—India included—sit up and take notice. The mandarins in India’s Health Ministry’s corridors of power should, by now, realise the ban is useless, and its reversal is a necessity, say experts. It can and should never be considered an indulgence. India, in fact, must consider humane, risk-proportionate regulations while incorporating safeguards to prevent uptake, experts say. But it has not happened for the last three years despite the world taking the right kind of steps. India, sadly, has not changed, not budged.
Indians bear an enormous tobacco burden. Worse, nearly a third of the population is dependent on some form of tobacco. This, in turn, leads to nearly 14 lakh deaths, almost the total population of Ranchi or Jabalpur. And then, the WHO says the whopping loss of $27.5 billion annually is due to diseases related to tobacco use for persons aged 35 and above.
There are countless laws the Ministry of Health has initiated to prevent or dissuade people from smoking. But the most controversial is the decision it took on the vaping industry. For example, the Framework Convention on Tobacco Control (FCTC) treaty specifically states that “harm reduction”—the reduction of the well-known harms of smoking by substituting safer alternatives—is one of the main pillars of global tobacco control. But then, the WHO refuses to endorse any of the many safer nicotine alternatives to combustible tobacco. Scientists across the world have repeatedly said vaping is the best to use proven cessation tools.
But then the WHO, also a prolific purveyor of misinformation about reduced harm alternatives, refuses to take note. It remains content with its cherry-picked science, misleading information and many assertions that are simply not true.
Consider this one. If the FCTC approach to tobacco control was replicated for fossil fuels used for transport, it would be more likely that national governments would be urged to prohibit electric vehicles in favour of there being no automotive transport whatsoever. With the FCTC as a benchmark, fossil fuels would never be eradicated due to ideological objections to alternatives.
As a result, far from being a template on which international treaties in other policy areas should be based, the WHO FCTC is not even a success in its own field. For example, a recent study published in the British Medical Journal found “no evidence to indicate that global progress in reducing cigarette consumption has been accelerated by the FCTC treaty mechanism,” while earlier this year two former WHO directors wrote in the Lancet that: “The FCTC is no longer fit for purpose, especially for low-income countries.” When the FCTC was formed in February 2005, there were 1.1 billion smokers in the world; there are now 1.3 billion.
So, what needs to be done, especially for India? Experts say, anti-smoking policies must offer realistic solutions for smokers. Prevention and cessation have been and are key pillars in the fight against smoking. India must understand these types of actions are fundamental and should continue to be a central support to avoid initiation and achieve smoking cessation. However, cessation and prevention alone are not efficient to reduce the high smoking rates most effectively, as they do not offer a sufficient solution for those people who do not manage to quit smoking through the usual tools. In this sense, it is necessary to incorporate new tools that help modernise policies and minimise the harm that smoking causes to people who smoke.
And then, scientific advances, not opinions, must be the cornerstone of the fight against smoking. Indian health ministry officials are being reminded time and again that as with any issue affecting public health, science should be at the core of any health plan, not preconceived ideas, sensationalism or opinions. In the case of e-cigarettes, heated tobacco, snus and other nicotine products with harm reduction potential, science has already proven in many cases that they are far less toxic than combustible cigarettes and can also help people quit smoking and reduce disease rates in the population, making these devices potentially great tools to help those who do not succeed in quitting, as long as they are properly and specifically regulated to avoid use by never smokers.
For example, as a result of this scientific evidence, the UK public health agency recently announced that the UK will be the first country to prescribe medically authorised e-cigarettes for smoking cessation within its National Health Service.
The Daily Express of London said vaping gear scientists in the UK have concluded that vaping products should be put on prescription to help millions kick their smoking habits. This is a significant change; the reports have been sent to India’s Health Ministry by those arguing against the ban. The prescriptions would soon start. England, then, would become the world’s first nation to prescribe e-cigarettes licensed as a medical product.
In private conversations, India’s health ministry officials admit the move is a big one with far-reaching impact for nations like India which continues to enforce the ban.