Anti-smoking researcher: banning e-cigarettes does not make sense

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Dr. Konstantinos Farsalinos, a well-known cardiologist and anti-smoke researcher, talked about the status of e-cigarettes in India: Although research has shown the effectiveness of e-cigarettes as a smoking cessation tool and India is one of the countries with the largest smoking population in the world, local lawmakers still Continue to fight for related smoking ban policies.

According to a June report from the Indian Press Trust, a proposal by the Indian Pharmaceutical Technical Advisory Committee recommended that, under Articles 26A and 10A of the 1940 “Drugs and Cosmetics Act”, the sale, production, import and distribution of all e-cigarette products be prohibited . The proposal states, “After reconsidering its earlier review, the Drug Advisory Committee recommended that these devices belong to the definition of’drug’.

In addition, the Indian Medical Research Council (ICMR) strongly recommends this initiative, which recommends a “total ban” on e-cigarettes, saying that such devices become a gateway to smoking and can attract non-smokers to become addicted to nicotine. This statement can be said to be ironic, at least, when the device that is proved to be a safer alternative is banned, the actual toxic product: cigarettes has not been affected and is widely used nationwide.

In 2017, the Federal Ministry of Health of India established a working group to assess the impact of e-cigarettes on local vapers and try to find out whether a ban is necessary. The committee concluded that these products have carcinogenic properties and are highly addictive. Based on these arguments, the federal government has stated that it plans to implement the ban.

Then in September last year, in a consultation report by the state government, the Ministry of Health recommended that e-cigarettes and heating and non-combustion equipment be banned because they pose a threat to the public, especially children and adolescents, pregnant women and women of childbearing age.”

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At the same time, Dr. Konstantinos Farsalinos, a well-known anti-smoking researcher, banned e-cigarettes in a comprehensive manner. He said that this stance would have a negative effect on the local smoking epidemic. The following ET cardiologist article discusses this situation in more detail:

“While India continues to combat rampant tobacco use, especially smoking, policy makers are still struggling to understand the concept of e-cigarettes. E-cigarettes or electronic nicotine delivery systems (ENDS) are innovative harm reduction nicotine delivery systems that do not involve combustion, As a result, reduced emissions and toxic by-products are produced by at least a certain order of magnitude.

Around the world, ENDS is now touted as a mature tool to reduce the harm caused by smoking. There is no doubt that they also have great potential to improve the public health outcomes of tobacco-dependent populations like India.

In 2018, the Federal Ministry of Health and Family Welfare issued an advisory opinion to all states, recommending that they prohibit the sale, manufacture, or use of ENDS. Even the Indian Medical Research Council has advocated pan-India banning ENDS. This is in stark contrast to the comprehensive regulatory approach taken by countries such as the United Kingdom, New Zealand, Canada and the European Union, which maximizes population-level benefits through less harmful alternatives (such as ENDS).

Currently, it is reported that the government plans to amend the “Drugs and Cosmetics Law”, including a ban on ENDS. This will only reduce the choice of smokers who want to switch to harm-reducing alternatives. In addition, the nature under the “Drugs and Cosmetics Act” is also questionable, because ENDS is significantly different from therapeutic products because they are just to reduce smoking-related injuries and do not claim to have therapeutic value. In most countries, ENDS is considered as a separate category with its own standards and regulatory framework.

The rigidity of the government is also accompanied by the medical community’s unfounded suspicion of ENDS. Worryingly, sometimes biases and tendencies are better than unbiased reviews of the exhaustive literature of ENDS, and most people believe that the strong risk reduction associated with ENDS is used as a smoking substitute. I am particularly worried that well-known doctors claim that ENDS is as harmful as cigarettes. Nothing can go further from the truth, the medical community should protect their reputation and respect their ultimate responsibility to provide reliable and balanced information about the available evidence of ENDS (and any other general medical subjects).

Although I admit that the medical community’s main concern is the lack of long-term research on the health effects of ENDS, it should not be the cause of the current paralysis. We already know enough about the physical and chemical processes involved, the toxicology of the emissions and the exposed biomarkers; there is no doubt that ENDS is less harmful than smoking. This is supported by countless leading public health agencies worldwide.

At the same time, we do know that existing products (combustible cigarettes) are extremely harmful, so the choice should be straightforward. ENDS and its potential impact should be related to cigarettes. When viewed in this way, it is obvious that banning ENDS is meaningless when cigarettes and other forms of tobacco are legally available. “

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