India’s vape ban has been enforced for six long years, in a country where smoking kills over 1 million people annually. The 2019 Prohibition of Electronic Cigarettes Act banned the sale, storage and manufacture of these safer alternatives. Some influential voices have just added to urgent calls for its repeal.
Doctors Vaibhav Sahni and Abhishek Shankar from the respected All India Institute of Medical Sciences (AIIMS) in New Delhi have published a much-needed commentary, “Impact of Banning Electronic Nicotine Delivery Systems in India.”
“Since the ban was instituted, evidence has accrued to the extent that a relook into the Electronic nicotine delivery devices (ENDS) policy is warranted,” said Dr. Sahni, a scientist in the Department of Radiation Oncology at AIIMS.
“ENDS are a form of harm reduction … [and] can be looked at for their cessation benefits.”
There is a mountain of evidence from around the world that vapes—as well as other safer nicotine options that India also bans, like nicotine pouches, snus and heated tobacco products—help people quit smoking and are more effective than traditional nicotine replacement therapies.
“ENDS are a form of harm reduction and in a scenario where proven carcinogens such as alcohol and tobacco are not banned … certainly something like ENDS can be looked at for their cessation benefits with strict legislation and caution,” said Dr. Shankar, an assistant professor in the same department.
The doctors have courageously taken this position despite AIIMS’ official and unwavering support for the ban. In an August 10 press release, AIIMS stated: “The All India Institute of Medical Sciences, New Delhi, issues this clarification in response to media reports referencing an opinion on Electronic Nicotine Delivery Systems by two doctors from AlIMS, New Delhi. We clearly reiterate this institutes’ clear and long-standing position opposing any form of tobacco and nicotine use, including e-cigarettes.”
“Any views expressed by individual researchers are personal & not the institute’s official stance,” the institute added. “We fully support India’s 2019 ban on ENDS.”
The stakes are high when India has some of the world’s highest rates of tobacco use. An estimated 253 million people use tobacco in forms such as bidis (unprocessed tobacco rolled in leaves to be smoked) and gutkha (chewing tobacco with much higher risks than snus or pouches), as well as cigarettes.
“As a harm reduction advocate in India, I welcome the call for an evidence-based re-evaluation of India’s ban on electronic nicotine delivery systems,” Jagannath Sarangapani, a member of the Association of Vapers India, told Filter. “Countries like the UK have shown that harm reduction can work hand-in-hand with strong public health safeguards.”
“It’s time India modernizes its tobacco control policies in line with global best practices.”
As tobacco harm reduction activists in India predicted, the vape ban has been a complete failure, and the products have become widely available through a massive illicit market that includes local shops and online platforms.
“Prohibition has not eliminated nicotine use,” Sarangapani said, “it has merely pushed it into unregulated and potentially more dangerous channels.”
The inevitability of this process has been highlighted even in the United Kingdom, which had been known for vape-friendly policies. There, a recent ban on disposable vapes hasn’t succeeded in making these products disappear; they continue to be sold on the illicit market and at retail outlets.
It is of vital importance that doctors who work with cancer patients in India are going public about the vape ban and are making the case for the regulated use of safer nicotine products. After all, they are the ones who witness on a daily basis the preventable death, disability and suffering that smoking-related illnesses cause.
Dr. Sahni believes that it is prudent to examine evidence in order to evaluate whether a policy is still on the right track. Sarangapani agrees, saying, “It’s time India modernizes its tobacco control policies in line with global best practices.”
Photograph by Mayank Singh via Global State of Tobacco Harm Reduction/Flickr/Creative Commons 2.0
