Seeking to dispel the popular notion that e-cigarettes are safe and nicotine-free and a safer substitute to normal cigarettes, the Indian Medical Association has started a mass awareness campaign to educate people as well as the medical fraternity on the issue.
The IMA today released a white paper on it which stated that "E-cigarettes are battery-operated devices that heat a liquid to produce a vapour that the user inhales."
"Unlike conventional cigarettes, which burn tobacco and generate smoke, e-cigarettes have a cartridge containing a liquid (sometimes referred to as 'e-liquid'), which contains nicotine and other constituents. The liquid is heated to produce a vapour the user inhales," the paper said.
"Nicotine exposure from e-cigarette use, as with cigarette smoking, increases heart rate and produces measurable levels of blood cotinine, a nicotine metabolite. Experienced e-cigarette users tend to take longer puffs and use the device more intensively compared with novice users. As a consequence, they have higher blood nicotine levels that more closely resemble the levels achieved by smoking conventional cigarettes," Secretary General, IMA, K K Aggarwal said.
Given the concerns that e-cigarette use may be a gateway to nicotine dependence in adolescents, many public health authorities have recommended restricting e-cigarette marketing and advertising to youth, much in the same way that conventional cigarette smoking advertising is restricted.
"Most believe that inhaling e-cigarette vapour is likely to be less harmful than inhaling cigarette smoke but the consequences of chronic inhalation of e-cigarette vapour are unknown," he said.
"IMA, therefore, does not advocate e-cigarettes as an effective way to reduce smoking cessation and believe that they are as harmful as normal cigarettes and must not be promoted," Aggarwal said.
The nicotine in e-cigarette fluid poses a potential for accidental ingestion, especially by children. The typical five mL vial of e-cigarette liquid refill may contain a nicotine concentration of 20 mg/ml (100 mg/vial). The known lethal dose of nicotine is about 10 mg in children, he said.
E-cigarettes have been banned in some countries, including Brazil, Singapore, Canada, and Uruguay.
As per WHO, regulations are needed to stop promotion of e-cigarettes to non-smokers and young people, minimise potential health risks to users and non-users, stop unproven health claims about e-cigarettes, and protect existing tobacco control efforts.
