Anti-tobacco activists in India supporting a ban on e-cigarettes: a position endangering public health

By Dr Farsalinos

Some surprising statements from Indian anti-tobacco activists were published few days ago in local media. One of them, dean of a local Dental College, called e-cigarettes “the evil twin of cigarettes” and said that “Banning e-cigarettes at this stage is like nipping an evil in the bud”. Another one, director of a Public Health Institute said: “E-cigarettes, despite containing liquid nicotine, were being promoted as harmless and non-addictive. However, laboratory analysis proved all these claims to be wrong. They show that users of e-cigarettes were also exposed to carcinogenic chemicals”.

If this is the stance and position of scientists who are fighting the smoking epidemic, imagine the level of misinformation in the general public. India is a country where smoking and harmful tobacco use is thriving. The WHO GATS study found that 34.6% of adults use some form of tobacco, while about 1 million Indians die annually from smoking-associated disease (2010 data). For countries with high prevalence of smoking and harmful smokeless tobacco use (unfortunately snus is virtually non-existent in India), e-cigarettes should be considered a golden opportunity to reduce harm in a cost-effective manner. Instead of seeing public health authorities and the scientific community welcoming e-cigarettes and encouraging their use by properly educating consumers, we observe a campaign of misinformation and demonization of nicotine, ignoring that the basic purpose of public health is to reduce disease and death. The focus on nicotine is misleading because in reality none has ever died from nicotine dependence; disease and death is associated with the vehicle used to deliver nicotine. E-cigarettes are currently the strongest competitors of tobacco, and it is hard to understand why anti-tobacco activists are not supporting a product used to substitute (i.e. reduce) smoking.

Furthermore, such statements represent an indirect endorsement of tobacco cigarettes. In fact, it is a paradox to strongly support bans on e-cigarettes while at the same time tobacco cigarettes are available everywhere. Providing a competitive advantage to tobacco cigarettes in terms of availability and accessibility is in direct opposition to the true purpose and goals of these activists. Perhaps they do not see it, but they end up supporting tobacco cigarettes and other harmful forms of tobacco; this is the definition of public health harm.

I urge public health officials and anti-tobacco activists to become open-minded, be informed on the true aspects of e-cigarette use and potential to serve as a harm reduction product and provide proper and reliable education to the society concerning these products. This is a historic opportunity for countries like India to significantly reduce the burden of smoking-related morbidity and mortality. It would be a fatal mistake (literally) to miss this opportunity.

Note. Prof Michael Siegel has also written an interesting comment about this story in his blog.



Background Image

Header Color


Content Color