WHO report on E-CIGARETTES

Relevance: prelims/mains: G.S paper III: health and Science and Technology- developments and their applications and effects in everyday life.

E-CIGARETTES

As per a report of WHO, Electronic Nicotine Delivery Systems [ENDS] [also known as e-cigarettes] heat a solution to create an aerosol which frequently contains flavourants, usually dissolved into Propylene Glycol or/and Glycerin. ENDS aerosol contains nicotine, the addictive component of tobacco products. In addition to dependence, nicotine can have adverse effects on the development of the foetus during pregnancy and may contribute to cardiovascular disease.

The WHO report further says that although nicotine itself is not a carcinogen, it may function as a tumour promoter and seems to be involved in the biology of malignant disease, as well as of neurodegeneration. Foetal and adolescent nicotine exposure may have long-term consequences for brain development, potentially leading to learning and anxiety disorders. The evidence is sufficient to warn children and adolescents, pregnant women, and women of reproductive age against ENDS use and nicotine.

E-cigarette has not been separately classified under import policy and is being imported under different HS Codes.

Import of e-cigarette, its Accessories and Electronic Nicotine Delivery Systems (ENDS), for the last three years and current year is as under:

As per WHO Report on the Global Tobacco Epidemic 2017, the Governments of thirty countries, including Mauritius, Australia, Singapore, Korea [Democratic People’s Republic], Sri Lanka, Thailand, Brazil, Mexico, Uruguay, Bahrain, Iran, Saudi Arabia, and United Arab Emirates have already banned Electronic Nicotine Delivery System in their countries.

Ban on import is not possible unless there is a legal ban on domestic production, distribution and consumption.

Considering that health is a state subject, Ministry of Health & Family Welfare, Government of India, has issued an advisory on 28.8.2018 to all States and Union Territories to ensure that any Electronic Nicotine Delivery Systems including e-Cigarettes, Heat-Not-Burn Devices, Vape, e-Sheesha, e-Nicotine Flavoured Hookah, and the like devices that enable nicotine delivery are not sold [including online sale], manufactured, distributed, traded, imported and advertised in their jurisdictions, except for the purpose and in the manner and to the extent, as may be approved under the Drugs & Cosmetics Act, 1940.

Governments of Punjab, Karnataka, Mizoram, Kerala, Jammu & Kashmir, Uttar Pradesh, Bihar, Maharashtra, Tamil Nadu, Jharkhand, Himachal Pradesh, Puducherry, Rajasthan and Meghalaya have prohibited the manufacture, distribution, import and sale of Electronic Nicotine Delivery Systems.

About E-cigarettes:

What are electronic cigarettes?

Electronic cigarettes, also known as e-cigarettes, e-vaporizers, or electronic nicotine delivery systems, are battery-operated devices that people use to inhale an aerosol, which typically contains nicotine (though not always), flavorings, and other chemicals.

They can resemble traditional tobacco cigarettes (cig-a-likes), cigars, or pipes, or even everyday items like pens or USB memory sticks. Other devices, such as those with fillable tanks, may look different.

Regardless of their design and appearance, these devices generally operate in a similar manner and are made of similar components. More than 460 different e-cigarette brands are currently on the market.

Some common nicknames for e-cigarettes are:

• e-cigs
• e-hookahs
• hookah pens
• vapes
• vape pens
• mods (customizable, more powerful vaporizers)

How do e-cigarettes work?

Most e-cigarettes consist of four different components, including:

• a cartridge or reservoir, which holds a liquid solution (e-liquid or e-juice) containing varying amounts of nicotine, flavorings, and other chemicals
• a heating element (atomizer)
• a power source (usually a battery)
• a mouthpiece that the person uses to inhale
• In many e-cigarettes, puffing activates the battery-powered heating device, which vaporizes the liquid in the cartridge. The person then inhales the resulting aerosol or vapour (called vaping).

How do e-cigarettes affect the brain?

• The nicotine in e-liquids is readily absorbed from the lungs into the bloodstream when a person uses an e-cigarette.
• Upon entering the blood, nicotine stimulates the adrenal glands to release the hormone epinephrine (adrenaline).
• Epinephrine stimulates the central nervous system and increases blood pressure, breathing, and heart rate.
• As with most addictive substances, nicotine activates the brain’s reward circuits and also increases levels of a chemical messenger in the brain called dopamine, which reinforces rewarding behaviors.
• Pleasure caused by nicotine’s interaction with the reward circuit motivates some people to use nicotine again and again, despite risks to their health and well-being.

What are the health effects of e-cigarettes? Are they safer than tobacco cigarettes?

• Some research suggests that e-cigarettes might be less harmful than cigarettes when people who regularly smoke switch to them as a complete replacement.
• But nicotine in any form is a highly addictive drug. Research suggests it can even prime the brain’s reward system, putting vapers at risk for addiction to other drugs.
• Also, e-cigarette use exposes the lungs to a variety of chemicals, including those added to e-liquids, and other chemicals produced during the heating/vaporizing process.
• A study of some e-cigarette products found the vapour contains known carcinogens and toxic chemicals, as well as potentially toxic metal nanoparticles from the device itself.
• The study showed that the e-liquids of certain cig-a-like brands contain high levels of nickel and chromium, which may come from the nichrome heating coils of the vaporizing device.
• Cig-a-likes may also contain low levels of cadmium, a toxic metal also found in cigarette smoke that can cause breathing problems and disease.
• More research is needed on the health consequences of repeated exposure to these chemicals.

Can e-cigarettes help a person quit smoking?

Some people believe e-cigarettes may help lower nicotine cravings in those who are trying to quit smoking. However, e-cigarettes are not an FDA-approved quit aid, and there is no conclusive scientific evidence on the effectiveness of e-cigarettes for long-term smoking cessation. It should be noted that there are seven FDA-approved quit aids that are proven safe and can be effective when used as directed.

E-cigarettes haven’t been thoroughly evaluated in scientific studies. For now, not enough data exists on the safety of e-cigarettes, how the health effects compare to traditional cigarettes, and if they are helpful for people trying to quit smoking.