Sold as “A healthy substitute to cigarettes” and are promoted as an alternative to control or even stop smoking, considered safer than the other nicotine replacement products such as patches. It is a highly addicting and potentially lethal product, widely promoted through social media, email marketing etc. with discount offers.
Electronic Nicotine Delivery System (ENDS) popularly known as e-cigarette is a hand held electronic device that vaporizes a flavored liquid, which the user inhales. Using e-cigarettes is called vaping. The device uses battery-powered cartridges to produce a vapor which is considered unsafe.
There is no scientific evidence available that these are more helpful as cessation devices that other proven pharmacological agents.
The long-term effects:
- Throat and mouth irritation, vomiting, nausea, and cough.
- According to 2014 WHO report, ENDS use poses serious threats to adolescents and fetuses.
- The 2015 Public Health England report concluded that e-liquids can thermally degrade and produce high levels of formaldehyde.
- Nicotine, a key ingredient in e-liquids is as addictive as heroin and cocaine.It is associated with cardiovascular diseases; The nicotine content in e-cigarettes is adequate to sustain nicotine dependence.
- Being a vasoconstrictor its usage can lead to brain stroke, angina, heart attack, severe pain in the legs and even gangrene.
- Exposure to nicotine during adolescence can harm brain development.
- An aerosol emitted by it contains at least 10 chemicals that can cause cancer, birth defects or reproductive problems.
- E-cigarette use by a parent might lead to inadvertent health risks to offspring.
- Studies have shown the nicotine dependence may be transmitted maternally and genetically.
- Accidents like contact with liquid nicotine, fires due to vaporizer malfunction and explosions due to prolonged charging. Explosions are caused by an increase in internal battery temperature and can result in severe skin burns.
- Might cause an electrical waste problem.
E-cigarettes are mostly manufactured in China. In 2009 Canada and Australia banned e-cigarettes.
According to the World Health Organization (WHO) report in July 2014, there is limited evidence that e-cigarettes may help smokers to quit, instead the smokers should be encouraged to use approved methods for help with quitting.
In the same year, the US FDA said “E-cigarettes have not been fully studied, so consumers currently don’t know: the potential risks of e-cigarettes when used as intended, how much nicotine or other potentially harmful chemicals are being inhaled during use, or whether there are any benefits associated with using these products.
Additionally, it is not known whether e-cigarettes may lead young people to try other tobacco products, including conventional cigarettes, which are known to cause disease and lead to premature death.”
The United States Preventive Services Task Force in 2015, concluded that there is insufficient evidence to recommend e-cigarettes for smoking cessation, and recommended more proven smoking cessation aids. The National Institute on Drug Abuse said that e-cigarette could perpetuate nicotine addiction and thus interfere with quitting. The American Academy of Pediatrics also strongly recommended against the usage of e-cigarettes to quit smoking, stating that for teens, e-cigarettes are not effective in treating tobacco dependence.
The FDA Commissioner has recently written to the Union Health Ministry to ensure that Internet sites do not sell e-cigarettes. Worries about possible health risks have led to some countries talking of restricting its use, as in the UK and India.
The Drugs and Cosmetics Act of India allows nicotine (2mg-4 mg) only as gums and lozenges to be manufactured and sold. Punjab became the first state of India to declare ENDS as illegal in 2013 under this act. Under The Poisons Act of 1919, Punjab Poisons Possession and Sale Rules, 2014 was framed. According to this act, nicotine is a poison and it is necessary to possess a license to sell it. The Punjab and Haryana High Court has taken serious cognizance of the matter of nicotine in liquid form.
In 2013, the State Drugs Controller had issued a circular declaring e-cigarette as an “unapproved drug”.
With technical guidance from Punjab, Maharashtra, Karnataka and Kerala have also declared these products as illegal.