Saturday March 24, 2018

Banning E-Cigarettes Deprives Indian Smokers of a Less Harmful Alternative: Experts

The government is allowing the sales of lethal nicotine-containing products while banning a substantially less harmful alternative

Ban on e-cigarettes, Pixabay

Sep 02, 2017: Banning e-cigarettes may deprive Indian smokers of a substantially less harmful alternative, which can be against public health and can result in adverse consequences, experts have warned.

Some states in India, including Jammu and Kashmir, Karnataka, Punjab, Maharashtra and Kerala, have prohibited sales of e-cigarettes, while tobacco cigarettes remain legal.

According to media reports, the Union Health Ministry has recently ruled out acceptability of e-cigarettes in the light of research findings by experts who concluded that they have cancer-causing properties, are highly addictive, and do not offer a safer alternative to tobacco-based smoking products.

However, health experts argued that such decision creates a paradox. The government is allowing the sales of lethal nicotine-containing products — tobacco cigarettes — while banning a substantially less harmful alternative.

“In my opinion, banning e-cigarettes is against public health. I think it’s going to have an impending adverse consequence, because the ban will deprive Indian smokers of a substantially less harmful alternative,” Konstantinos E. Farsalinos a research fellow at the Onassis Cardiac Surgery Centre in Athens, Greece, told IANS in an interview.

Also Read: E-Cigarettes loaded with nicotine-based liquid may be as Harmful as Smoking, Says Research

“Banning is a hasty decision and can be counter-productive, because we are not aware of the extent of e-cigarette use or its harm in India,” added R.N. Sharan, Professor at North-Eastern Hill University in Shillong, Meghalaya.

An e-cigarette is a battery-operated device that uses a liquid “e-liquid” that may contain nicotine, as well as varying compositions of flavourings, propylene glycol, vegetable glycerin, and other ingredients.

In tobacco cigarette, there is combustion, a burning of an organic material, which generates temperature up to 900 degree Celsius, and thus produces all the harmful material.

Whereas, in e-cigarettes there is neither combustion nor tobacco. There is only the burning of the liquid, made up of ingredients approved for food and contains minimal burning, which is 100-1000 times lower compared to tobacco cigarette.

A study published in the journal The Lancet showed that India has 11·2 per cent of the world’s total smokers. Over 11 per cent of 6.4 million deaths worldwide was caused by smoking in 2015 and 52.2 per cent of them took place in China, India, Russia, and the US, the report said.

Further, the experts contented that banning e-cigarettes is contrary to worldwide trends.

Various studies conducted in the US, UK and other countries in the European Union, have shown that e-cigarettes have resulted in a significant decline in smoking rates.

Several countries like Switzerland, Belgium, New Zealand, Canada and the US, which were formerly advocating for bans, are now moving towards lifting the bans on e-cigarettes, Farsalinos said.

“Earlier in July, the US FDA cancelled the intended regulation saying that e-cigarettes may probably help a substantial proportion of smokers to quit smoking and switch to less harmful alternative,” Farsalinos said.

“The UK’s Royal College of Physicians recently advised the UK Government to promote the use of e-cigarettes (along with conventional nicotine replacement methods) as widely as possible as a substitute for smoking,” Farsalinos stated.

A survey of over 27,000 participants all over Europe, published in Eurobarometer in 2016, showed that more than one-third of e-cigarette users polled reported smoking cessation and reduction.

“With India being devoid of good monitoring systems and rich data of research, it should take cue from these countries. Ignoring the evidence from other countries, while the country doesn’t have much of its own, and deciding on bans, can be a bad idea,” Farsalinos said.

Importantly, e-cigarettes appear to be effective when used by smokers as an aid to quitting smoking.

The hazard to health arising from long-term vapour inhalation from the e-cigarettes is unlikely to exceed five per cent of the harm from smoking tobacco, the experts said.

“While, its not absolutely safe, it is 95 per cent less harmful than tobacco cigarette,” Farsalinos said, adding: “We don’t recommend it to a non-smoker. We always say it’s a product for smokers, and should be used as a smoking substitute.”

However, it is best to quit smoking without use of any alternative.

Farsalinos said that although marketing for e-cigarettes is essential, it needs to be done with strict regulation.

There is also an urgent need to create a competitive environment between a less harmful product and tobacco cigarette, which includes accessibility and price, the experts said. (IANS)

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Cigars, Pipes Tied To Same Risks As Cigarettes

Traditionally, doctors have asked just whether people smoked cigarettes, but they should instead be questioning patients more broadly about tobacco use

E-cigarettes is considered to be safer than tobacco cigarettes. Pixabay
  • Cigarettes are not the only tobacco products which can cause death
  • Other tobacco products like cigars and pipes are just harmful
  • All these tobacco products can cause cancer

Cigarettes are not the only type of tobacco products that can lead to premature death or fatalities from smoking-related cancers, a U.S. study confirms.

While people who exclusively smoke cigarettes have twice the risk of premature death from all causes compared to people who avoid tobacco altogether, exclusive cigar smokers have a 20 percent higher risk of early death, researchers report in JAMA Internal Medicine.

Cigarettes are not the only harmful tobacco products available in the market. Pixabay
Cigarettes are not the only harmful tobacco products available in the market. Pixabay

When it comes to fatalities from specific cancers that have been tied to tobacco use, cigarette smokers have four times the risk of people who never used tobacco, but cigar smokers are 61 percent more likely to die of these cancers and pipe users have 58 percent higher odds.

“We knew exclusive users of cigars and pipes were at greater risk of disease than people who do not use tobacco,” said lead study author Carol Christensen of the U.S. Food and Drug Administration’s Center for Tobacco Products. “However, this study provides information that reflects today’s patterns of tobacco use.”

Also Read: Banning E-Cigarettes Deprives Indian Smokers of a Less Harmful Alternative: Experts

These data “underscore the importance of complete quitting,” Christensen said by email.

For the study, researchers examined nationally representative survey data, collected starting in 1985, from 357,420 participants who were followed through 2011.

Overall, 203,071 people, or about 57 percent, never used tobacco at all. Another 57,251 participants were current daily cigarette smokers, while 9,414 said they had a less frequent habit and 77,773 were former cigarette smokers.

In addition, 531 people were current daily cigar smokers, while 608 individuals used cigars less frequently and 2,398 had quit.

For pipes, 1,099 participants had a current daily habit, while 78 people used pipes less often and 5,237 had quit.

Pipes, hookahs and all other tobacco products are just as harmful as a cigarette.
Pipes, hookahs and all other tobacco products are just as harmful as a cigarette.

During the study period, 51,150 people died of all causes.

With a daily cigarette, cigar or pipe habit, people had an elevated risk of death from tobacco-related cancers including malignancies of the bladder, oesophagus, larynx, lung, mouth and throat, and pancreas.

Nondaily users

Even with a nondaily cigarette habit, people were more than six times more likely to die of lung cancer than individuals who never used tobacco. They also had more than seven times the risk of dying from a chronic obstructive pulmonary disease, more than four times the odds of death from oral cancers, and 43 percent higher odds of death from a circulatory system disorder.

Current cigar smokers had more than three times the odds of dying of lung cancer, and for current pipe smokers, the risk was 51 percent higher, compared with never-smokers.

The results were limited, however, by the relatively small numbers of cigar and pipe smokers in the sample, the authors noted.

Cigarettes, hookah, pipes, cigars all are equally harmful.
Cigarettes, hookah, pipes, cigars all are equally harmful.

Another limitation was that survey questions about tobacco use changed over time and didn’t determine how often nondaily smokers might have used cigarettes, cigars or pipes.

Even so, the results suggest that doctors may need to broaden how they discuss smoking with patients to make sure people understand they’re at risk even when they don’t have a daily habit, said Dr. Michael Ong of the University of California-Los Angeles and VA Greater Los Angeles Healthcare System.

Also Read:  Beware! Vapor smoke from E-cigarettes are just as harmful, says a new research

“Patients often do not associate the occasional use of cigar or pipes with health risks, but this study shows that current, particularly daily, cigar use is associated with increased overall risk of death,” Ong, who wasn’t involved in the study, said by email.

Doctors also need to broaden their message about smoking and cigarettes to include other tobacco products that are becoming more popular, said Judith Prochaska, a researcher at Stanford University in California who wasn’t involved in the study.

Smoking e-cigarettes are not a healthier alternative to smoking. cigarettes Pixabay

Traditionally, doctors have asked just whether people smoked cigarettes, but they should instead be questioning patients more broadly about tobacco use, Prochaska said by email.

“The tobacco landscape has been changing dramatically,” Prochaska added. “While cigarettes remain the primary tobacco product used, cigars, smokeless tobacco, e-cigarettes, hookah, and even pipe tobacco have seen gains in use, while cigarette use in the U.S. has been declining.” VOA