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Consumer body questions veracity of ICMR white paper on ENDS


Press Trust of India New Delhi
A consumer body has questioned the veracity of ICMR white paper on Electronic Nicotine Delivery Systems (ENDS), saying empirical evidence from countries that have allowed e-cigarettes show "smoking rates have declined at a historic pace".
The Association of Vapers India (AVI) was reacting to the white paper released Friday by the Indian Council of Medical Research (ICMR), the apex research body, which has recommended a "complete" ban on ENDS, including e-cigarettes.
It said their use can initiate nicotine addiction among non-smokers and adversely affects health in a way similar to cigarette smoking.
ENDS are devices that heat a solution to create an aerosol, which also frequently contains flavours, usually dissolved into propylene glycol and glycerin.
The white paper published by Indian Council of Medical Research (ICMR) does not present the true picture on ENDS, AVI said.
"The findings of the ICMR paper run counter to empirical data from countries where e-cigarettes are regulated and research conducted by some of the most credible organisations in the world.
"This could be because they have cherry-picked studies to make a targeted case against e-cigarettes," Samrat Chowdhery, the director of AVI, said.
AVI said contrary to claims made in the white paper that these devices have no net population-level benefit, "empirical evidence from countries which have allowed e-cigarettes shows that smoking rates have declined at a historic pace as more and more smokers make the switch".
Over 40 million smokers worldwide have transitioned to risk-reduced alternatives in less than a decade according to market research agency Euromonitor. This represents a significant public health gain, which has resulted in lowest-ever smoking rates in the UK, many parts of the EU and the US where e-cigarettes are gaining popularity, AVI said.
Dr Rohan Sequeira, a cardio metabolic physician at the Jaslok Hospital in Mumbai, said, "Many research bodies from Public Health England (PHE), US FDA, American Cancer Society (ACS), Cancer Research UK and others have found e-cigarettes significantly (at least 95 per cent) less harmful than conventional combustion cigarettes".
Chowdhery pointed out that the precautionary principle cited by ICMR in pushing a ban on safer alternatives is wrongly applied.
It also alleged that the health ministry had taken a hardline view on ENDS by issuing a notice to all centrally funded institutions earlier this month barring them from publishing any ENDS research or even participating in discussion about it.
The ICMR officials and scientists, who have studied over 250 research papers on nicotine delivery devices to create an official stance for India, stated that e-cigarettes are also harmful to non-users and have adverse health impacts even when people are exposed to second-hand vapours.
"Passive exposure to vapours during pregnancy can severely affect the health of both the mother and the foetus. There are reports of poisoning due to accidental swallowing by children. These devices can also cause fire and explosion.
"Use of ENDS or e-cigarettes by non-smokers can lead to nicotine addiction and regular smoking," the white paper stated.
The white paper highlighted that there is very limited evidence regarding the impact of ENDS on tobacco smoking cessation, reduction in cigarette use or adverse health effects.
ENDS are advertised through various forms of media, with youth being the target group, and are being marketed as safer alternatives to conventional cigarettes or harm reduction products, in a glamorous manner.
These techniques are aimed at targeting the youth and children, it said.
"It is also noteworthy that major tobacco companies have purchased or developed ENDS products, with the dual commercial intent of expanding their range of tobacco products while touting their ability to offer a product that they claim reduces harm from the cigarettes.
"Cigarette smokers who may have otherwise given up the habit are thereby retained as nicotine-addicted customers, while those who may have never attempted to experiment with cigarettes are drawn into the nicotine addiction web.
"This duality of product marketing is a business strategy adopted by tobacco companies who see conventional cigarette smoking diminishing in many countries," the white paper claimed.
The sale of e-cigarettes is completely banned in 25 countries, including Brazil, Norway and Singapore, while market authorization is required in 17 other countries.
In the United States, ENDS, that are marketed for therapeutic purposes are currently regulated by the US-FDA and the Center for Drug Evaluation and Research, the white paper stated.

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First Published: May 31 2019 | 9:05 PM IST

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