Born and raised in Mumbai, Aditi Sharma now lives in Pune, a sprawling city in the western Indian state of Maharashtra, and works long, odd hours at a popular English-language daily newspaper. After watching her husband, another longtime smoker, use an open-system vape to get himself off combustible cigarettes, she decided to give it a go, too. Eventually, the effort stuck. She felt healthier. She could exercise more easily. She didn’t smell of smoke.
But whenever the New York Times publishes a new article about JUUL, Sharma has to defend vaping to her newsroom. Her peers are well aware that the past two years have been contentious for the company in the United States, as countless stories have circulated about its former marketing toward the country’s youth and, then, its pursuits abroad.
Her coworkers were always curious, though, despite their skepticism. Wasn’t vaping as dangerous as smoking? Wasn’t it making people sick in the US? Wasn’t it attractive to kids? It’s often too complicated to contextualize vaping as a harm reduction tool in these conversations, Sharma told Filter, but she feels she has to try anyway.
More recently, however, her colleagues have only had a single question: What are you going to do? Because according to Indian law, e-cigarettes are effectively illegal.
The decision was reached in order to protect “the health of our citizens, of our young.”
In September 2019, Nirmala Sitharaman, India’s finance minister, announced a ban on vaping products—an ordinance, passed months later by parliament, that would “prohibit the production, manufacture, import, export, transport, sale, distribution, storage, and advertisement of e-cigarettes.” It was unfortunate that “e-cigarettes got promoted initially as a way in which people can get out of the habit of smoking cigarettes,” Sitharaman stated after a cabinet meeting that fall. “It was to be a weaning process from using cigarettes.”
The decision was reached, she continued, in order to protect “the health of our citizens, of our young.”
The measure came with strict consequences. A first-time violation can lead to a year in prison, and a $1,400-equivalent fine; additional offenses can mean all the way up to five years in prison, and a $7,000 fine. Such penalties include not only sales or distribution, but personal storage of devices or e-liquids—including having stockpiled them prior to the ban.
Amendments and updates since have only made the legislation worse for vapers: In February, India’s aviation authority banned carrying vaping products on airplanes, meaning that even before the pandemic, a vaper could not go on vacation in London, say, and fly home with a bundle of supplies.
From the start, many Indian vapers considered Sitharaman’s announcement—coming from the government official in charge of the finance ministry and not the public health department—to be telling. It might have actually been symbolic. The Indian government owns a significant stake in the nation’s largest tobacco company, ITC, and India itself is one of the biggest tobacco cultivators on the planet. So “if you want to fight Big Tobacco in India,” said Indian vaper Aryan Sharma, “you have to fight the government itself.”
A Community Under Siege
The story of a vape-less India, a narrative often overlooked by the Western press, is a major tragedy in the developing war against vaping and tobacco harm reduction, where monied interests and the reaction to the subject in the US may have doomed a lifesaving technology in India.
As of 2018, India held 12 percent of the world’s billion smokers, constituting about 14 percent of the country’s population, or 120 million total smokers. If you count tobacco use in any form, like the popular bidis (unprocessed tobacco rolled in leaves) or gutkha (chewing tobacco), India’s tobacco-use prevalence jumps up to 29 percent, making it the world’s second largest consumer after its neighbor China.
Indian vapers’ battle against the government is not one that they are sure they can win. Stuck in the same position since last September, many are, unfortunately, resigned to their reality, even if they’re not totally sure how they arrived here.
“Vaping is such a small issue,” a Hyderabad-based vaper and consumer advocate named Rizwan told Filter. “People aren’t willing to pop their heads out for this.”
“In the past six months, I haven’t met anybody who has picked vaping up.”
Filter spoke with nearly a dozen vapers, researchers, and consumer activists in India, hoping to develop a sense of what life was like a year after the ban and what the future had in store. All told similar and familiar tales: The government’s prohibitory moves have expanded the country’s illicit market of vaping products; driven vapers back to cigarettes; slowed down, if not outright stopped, scientific research on the topic; and, despite the fact that personal consumption is technically legal, stigmatized the act of vaping, likely preventing current smokers or tobacco users from switching. (Some people, fearing criminal or civil actions, requested anonymity to speak freely about vaping for this article.)
“In the past six months,” Aditi Sharma told Filter, “I haven’t met anybody who has picked vaping up.”
Vaping throughout India, in other words, has seemed to disappear out of necessity. At least in public. Aryan Sharma, a producer and DJ based in Hyderabad (no relation of Aditi) said that he became tired of people asking him for hits off his vape. Before the ban, when he performed, he’d vape in smoking sections at bars and clubs. This was in a society before COVID: It was easy, and if a stranger wanted a rip, he didn’t mind. Why not?
But since soon after the ban, he hasn’t vaped outside his home. “Most of my work depends on what people perceive of you,” he told Filter. Without stable connections, he had enough trouble tracking down the products as it was, and he was sick of being asked to share his dwindling, marked-up e-liquid with strangers. Plus, he worried what others might think if he vaped publicly. Prohibition forced him into dual-use; he returned to smoking, at least when he wasn’t vaping inside his own walls.
“Sourcing is a huge problem,” said Dhaval Gogate, a vaping advocate in Pune. In the US, as individual states began to prohibit vaping, a seemingly vigorous illicit market was already in place, mainly because vaping emerged from this punk, do-it-yourself culture that pervades the industry. That is much less the case in India. The country’s nascent vaping community was thin, spread out, and vape shops were rare. Afraid of a crackdown by law enforcement, only 400 people throughout six cities protested the ban one Saturday last September, in the immediate aftermath of its introduction.
“Vaping is too much of a hassle now. “I don’t have control over the situation.”
Nonetheless, another vaper from Bangalore, who asked for anonymity, echoed Aryan Sharma’s sentiment. She said that vaping had once been “a great conversation starter in smoking spaces.” She grew into a de facto advocate when she was socializing, evangelizing vaping as a safer alternative to tobacco, particularly smoking. She had learned about vaping from her uncle, a hobbyist who tinkered with coils and mods in his basement, and realized that this was how the knowledge spread—through casual conversation, through word of mouth.
Anticipating the ban last September, she bought a ton of mango JUUL pods in New York (where they were, at the time, still legal to purchase in the city, and cheaper) and stored them in her apartment in India, divvying them out to friends who requested them.
She has since run out and, like Aryan Sharma, has returned to smoking cigarettes. “Vaping is too much of a hassle now,” she told Filter. “I don’t have control over the situation. And who really wants to rely on other people? It’s like scoring pot.”
The point is simple. “Consumers just want the right to make a choice about their own health,” said Samrat Chowdhery, the president of the International Network of Nicotine Consumer Organizations (INNCO) and the director of the Association of Vapers India (AVI).
As Chowdery knows, however, the stakes are much higher than that. India’s situation is not the same as that in the US, where vaping—like almost everything else—has become politicized and turned into something of a partisan argument between two passionate and at times overzealous groups. We have the vapers themselves—often libertarian-leaning consumer activists backed-up by tobacco-control scholars, notable scientists, and conservative tax reformists like Grover Norquist—and puritanical abstainers led by Michael Bloomberg and Matthew Myers’ Campaign for Tobacco-Free Kids, who understand vaping solely as a Big Tobacco ploy to hook a new generation to nicotine.
India is unique, in large part because it’s a lower-middle-income country (LMIC) and the second most populous nation in the world. There, vaping is a relatively new yet equally controversial phenomenon, tobacco prevalence is high (especially in rural areas without access to sufficient healthcare), nicotine replacement therapy is scant, and draconian moves—many of which are copied from the States, rather than countries with progressive strategies like the United Kingdom—have a greater effect on an already minimal public health infrastructure.
A vaper and shop manager in Hyderabad told Filter that, just prior to the government’s ruling last autumn, undercover law enforcement agents had raided the vape store he managed. He said the officers spent close to five hours there, scouring the inventory and asking questions about the rigs and e-liquids for sale. Even though they weren’t selling tobacco, the cops insisted that the owner needed to get a tobacco license to keep operating. “I understood, then, that this was something that the government wanted to nip in the bud,” the manager said.
US Influence on an Indian Health Disaster
Indian citizens have more to lose from the vape ban than do people in the US—both in terms of absolute numbers of smokers, and if you compare the US adult smoking prevalence of 13.7 percent (34 million people) with India’s total tobacco use prevalence of more than twice that figure.
India’s complex and robust tobacco landscape necessitates a nuanced, science-driven approach by policymakers—but that, of course, has not happened. As a result of the vape ban, “research is also indirectly banned” in India, said Dr. Sree Sucharitha, a professor of community medicine at Tagore Medical College and Hospital, as funding becomes harder and harder to obtain. “The educational systems and economic systems aren’t promoting study,” she told Filter.
A “hidden factor,” Sucharitha continued, might be that more, unignorable evidence of vaping’s harm reduction efficacy will emerge, and “there could be some kind of debate around it in the public domain.”
“There’s an almost imperialistic view. Why can’t you just simply quit?“
Instead, what you have are Western interests jockeying for influence over tobacco control policy in a country where they can interfere more successfully than their own. “There’s an almost imperialistic view,” said Gogate. “Why can’t you just simply quit? Well, if it was that easy, we wouldn’t have millions dying.”
These foreign players appear to be winning—an inescapable irony when you consider that the Portguese introduced tobacco into India centuries ago. For years, in this decade, organizations like the International Union Against Tuberculosis and Lung Disease—more commonly referred to as The Union—have been urging LMICs like India to halt the sale of e-cigarettes and heat-not-burn tobacco products (which the US Food and Drug Administration recently determined could be marketed in the US as a “modified risk tobacco product”).
Meanwhile, supposed philanthropic savior and nicotine prohibitionist Michael Bloomberg, a financial backer of The Union, has also sought to influence tobacco control in India so much so that his charity has repeatedly been under investigation by Indian authorities.
JUUL nearly entered the market in late 2019, backtracking at the last minute when India declared the ban. (The company tried to help challenge the law in court, but soon dropped the lawsuit.) “JUUL captured 70 percent of the pod market in the US,” Chowdhery told Filter. “I think the Indian government—and their tobacco company—was just financially spooked.”
There is, though, some good news for the wider world. “India is an outlier, being one of only four countries to have banned nicotine vaping products since 2018,” said Gerry Stimson, the director of policy and research at Knowledge Action Change** and a prominent harm reduction advocate in the UK. “Banning nicotine products is relatively rare,” he told Filter.
At the moment, 36 countries ban the sale of nicotine vaping products, a decrease from 39 in 2018, according to data from the upcoming report “Burning Issues: The Global State of Tobacco Harm Reduction 2020,” produced biannually by Knowledge Action Change and reviewed early by Filter. Some of these countries, like Japan and Brazil, didn’t explicitly ban e-cigarettes, however, but determined that they violated existing pharmaceutical laws; they will allow their sale after product review—not totally unlike the premarket tobacco product application (PMTA) process in the US.
“If the US decided vaping was ok, it would have a global impact.”
Whichever argument you support, vaping has not had good PR. Last summer—at the time that American journalists and public-health bureaucrats ramped up their focus on JUUL and India prepared to institute its ban—panic-driven coverage emerged about soaring rates of e-cigarette use among teenagers. Then, a spate of vape-related illnesses, known as “EVALI,” terrified the US. Those figures have since dropped drastically, and vape-linked disease and fatalities were later attributed to adulterated, illicit THC oil, not nicotine.
But the narrative is too far gone. To lawmakers, suggesting minor criticism of these policies typically borders on hearsay and almost always spurns some kind of reactionary, prohibition-minded response. Many US states—like New York, Massachusetts, California, and New Jersey—have instituted bans on nearly all flavors, and the federal government prohibits nearly all pod-based flavors. The sad conclusion is that the US has established a standard that the rest of the world has difficulty ignoring.
“If the US decided vaping was ok, it would have a global impact,” said Rizwan, the vaper from Hyderabad. “It’s just… So many other countries would fall in line.”
Photograph by Adam Cohn via Flickr/Creative Commons 2.0
* JUUL has provided an unrestricted grant to The Influence Foundation, which operates Filter. Filter’s Editorial Independence Policy applies.
** KAC has awarded scholarships to The Influence Foundation to support tobacco harm reduction reporting. Samrat Chowdhery and Sree Sucharitha have also been awarded tobacco harm reduction scholarships by KAC.