JOIN USElectronic cigarettes banned, but who’s even looking?
The Association of Vapers India (AVI) recently said the ban on e-cigarettes in Karnataka was ‘anti-people.’
In a PIL filed last year at the Karnataka High Court, the group produced evidence to say e-cigarettes were helping tobacco smokers quit.
E-cigarettes and cartridges are available online and delivered in Karnataka, despite the ban. Brick-and-mortar stores also sell them discreetly.
Not everyone is convinced e-cigarettes are okay.
About 1,000 doctors, 90 public organisations and 1,000 school students and teachers urged Prime Minister Modi to enforce a countrywide ban on e-cigarettes, also called electronic nicotine delivery systems (ENDS).
The rising popularity of e-cigarettes is a matter of concern. City doctors say e-cigarettes could be as harmful as regular cigarettes.
Dr Sachin Kumar, senior consultant (pulmonology), Sakra World Hospital says they are not safe.
“There is no quality control on the refills and cartridges of e-cigarettes. A sense of security encourages the craving for e-cigarettes,” he says. Over the last five years, about 30 per cent of all smokers (in the age segment of 18 to 35 years) have switched to e-cigarettes, he reckons.
“It’s considered the in-thing now. Of the total number who smoke e-cigarettes, 15 per cent are new young smokers. They slowly switch to cigarettes as adults later,” he says. Long-term effects of e-cigarettes include bronchitis, and cancerous growth in the lungs, urinary bladder, pancreas, and stomach, he warns.
Smoking e-cigarettes, also known as vaping (because nicotine gets vapourised) can be tricky, says Dr Rajshekhar C Jaka, head of the department-surgical oncology and robotic surgery, BR Life SSNMC Hospital.
“In cigarettes, there are a lot of harmful chemicals and the levels of carcinogen might be lower in e-cigarettes. This doesn’t mean they are totally safe,” he says.
As vaping is like smoking, many who have made the switch just smoke a cigarette when an e-cigarette is not at hand. They are unable to quit completely, he says.
E-cigarettes are available in many flavours and in the West, even children have picked up the habit.
“They start it for fun but as adults switch to smoking as they are addicted. Vaping is increasing even here as accessibility is easy,” he says.
In e-cigarettes, the quantity of nicotine ranges according to the company and its cartridges, which can result in people vaping even more than smoking just for the rush.
Dr (Prof) U S Vishal Rao, head neck surgical oncologist and robotic surgeon at HealthCare Global (HCG), says e-cigarettes are unregulated by state or federal laws, and manufacturers are not required to disclose ingredients or substances inhaled and exhaled by the user.
“The base solution contains propylene glycol which can cause eye, throat, and airway irritation and, with long term exposure, cause asthma in children,” he says.
The hazards are big. A 5 ml vial of e-cigarette refill solution can contain a nicotine concentration of 20 mg/ml (100 mg per vial). The known lethal dose of nicotine is estimated at about 10 mg in children and between 30 and 60 mg in adults, he says.
E-cigarettes are also popular because of indoor smoking restrictions. “The effect of the exhaled vapours is also a concern. A number of toxic and potentially carcinogenic compounds are found in the vapours, and they can pose a risk not only to the user but also to those around,” he says.
Vaping poses serious threats to adolescents and fetuses. In addition, it increases the exposure of non-smokers and bystanders to nicotine and a number of toxics, he says.
Quitting options
Using nicotine patches or gum is the way to go for those who want to quit smoking, says Dr Rajshekhar C Jaka, surgical oncologist, BR Life SSNMC Hospital.
“The treatment is suggested according to the number of cigarettes a person is smoking. If it is 20 per day, we suggest three or four nicotine gums and patches a day for three months,” he says.
The gums and patches are tapered down to two and then to one over nine months as withdrawal symptoms such as headaches and irritability show up otherwise.
Contrary view
Various views exist on vaping. Dr Neelesh Reddy, consultant oncologist, Columbia Asia Referral Hospital Yeshwanthpur, says no official studies say e-cigarettes are harmful.
“Such warnings are just used by the tobacco lobby to blind people. There is no significant harm attributed to e-cigarettes as they have just nicotine in them. Even if there are minor side effects, they are far better than those of tobacco,” he says.
Tobacco can cause cancer, heart disease, lung diseases, problems in the intestine, and these not occur with e-cigarette use, he contends.</p>
Effects of nicotine include losing weight and addiction, but it’s not as complicated as an addiction to tobacco, he says.</p>
The e-cig scene
- E-cigarettes were banned in Karnataka in 2016.
- They are available on most online platforms.
- Nicotine levels vary from brand to brand.