According to statistics, approximately 130 million people aged 15 and older currently smoke. However, although about 12 percent of the world’s smokers live in India, and up to 60 percent of the total number of cancers in the country are tobacco-related, the government seems to neglect all the opportunities given by alternatives to traditional cigarettes.
Samrat Chowdhery leads consumer advocacy in India with a focus on tobacco harm reduction. A former journalist, Mr Chowdhery is the founder-director of Association of Vapers India, and Secretary/Treasurer of the International Network of Nicotine Consumer Organisations.
Mr. Chowdhery, in October 2019 New Dehli banned all e-cigarettes over fears about youth vaping, saying the devices posed a health risk. One year later, did the government meet its goal of curb smoking habits among youngsters?
Though no prevalence data is available post the ban in late 2019, there is no indication of any major reduction in either smoking or vaping among the underage. The ban itself has been wholly ineffective as there was a weak mechanism to enforce it. The police have been charged with implementation, but no major arrests or seizures of e-cigarettes or e-liquids have been made since the ban. This could be because nicotine is freely available in many forms, from cigarettes to smokeless tobacco products, and singling out one variant for punitive action is practically unenforceable and difficult to justify as a top priority when the police force is already overburdened.
This has meant that vaping devices and liquids are still available, but now there are no safeguards to prevent their sale to minors as they are being sold through illegal channels. Infact there were more protections before the ban even though e-cigarettes were still not legal, because the vendors, in the hope of becoming recognised players, had imposed strict self-regulation measures. Those don’t exist now and it’s a free-for-all situation. We know from experiences in Thailand, Mexico and Brazil that banning e-cigarettes is an ineffective measure and gives rise to a black market, and yet the Indian government went ahead.
There is no indication of a dent on teen smoking either since cigarettes and the local smoking product, bidis, are sold per stick which is much cheaper for any teenager to afford than any kind of e-cigarette. A report did come out from the national cancer registry in 2020 which showed tobacco-related cancers are now over a quarter of all cancers in India and their number is projected to increase until 2025. So, if anything, India’s tobacco crisis is only becoming more severe, and the action against safer alternatives will further compound the problem.
What are the main consequences of the ban on vaping in the country?
Firstly, even though use of e-cigarettes is not banned, many vapers have been facing harassment from authorities who are ill-informed about the law. A month after the ban was passed in Parliament, the civil aviation authority, misinterpreted the law and imposed a ban on carrying vaping devices through airports and flights even if they were for personal use. This has led to a lot of hardship for vapers and visitors from abroad who are caught unawares. We are in the process of challenging this legally. Apart from this, the benefit India could have accrued from switching its huge smoking population of over 100 million has been lost or atleast severely dented as most smokers either don’t know safer alternatives exist, or can’t find or afford them.
What are the main socio-economic consequences of the prohibition of e-cigarettes?
An impact which has come into shaper focus because of the pandemic-induced financial shock is the lost economic potential from destroying an entire industry which could have created jobs and revenue, while saving lives. The e-cigarette industry in neighbouring China is growing rapidly, while India, which could have benefited significantly as it is among the largest producers of liquid nicotine, has let down its smoking population, struggling tobacco farmers and entrepreneurs. The social impact has been that many people now inaccurately think that vaping is more or as harmful as smoking, which could prevent smokers from switching.
Do you suggest the government should do more to implement Harm Reduction policies?
Certainly yes. India is quite progressive when it comes to drugs polices and those concerning communicable diseases like AIDS, with harm reduction forming the central pillar for intervention programmes. However, it is lagging far behind when it comes to tobacco harm reduction. We are at a stage where harm reduction in tobacco use is not even recognised as a valid intervention measure, and for this a lot of blame lies with a clutch of Bloomberg-funded NGOs which are leading the campaign against safer alternatives, along with the WHO. Added to this mix is Indian government’s direct participation in tobacco trade through its nearly one-third ownership of the country’s cigarette monopoly, which prevents it from taking real, impactful measures. What we have currently are token steps to appease WHO and other funders, but where action is really needed, such as providing meaningful quit support to tobacco users or NRT subsidies or giving them access to less harmful options, the government is found wanting.
It would help tremendously that the Indian government seriously consider risk-proportionate regulation of lower-risk tobacco products such that consumers can be guided towards lowering risk.