For e-cigarette to become a "promising alternative" nicotine replacement therapy, there is a need for further research on its long-term health effects and putting in place regulations to limit its sale to adults only, health experts have said.
M Siddiqi, the chairman of the Cancer Foundation of India in Kolkata, and R N Sharan, Professor of Biochemistry at North-Eastern Hill University, Shillong, have written to Health Minister J P Nadda regarding the issue.
"The Electronic Nicotine Delivery System (ENDS), which is more popularly known as electronic cigarette or e-cig, has emerged as a new generation NRT (nicotine replacement therapy). Systematically reviewing all the available literature on ENDS recently, one of us found that it may also offer an effective method of tobacco-smoking cessation," they said in the letter.
They said review showed that e-cigarettes could provide a safer and familiar way of meeting the physiological demands of nicotine to smokers, thus, helping them quit or cut down significantly on cigarette smoking.
"We, believe that ENDS to become a promising alternative NRT, there is an immediate need of further research on its long-term health effects. Furthermore, regulation should be put in place for quality controls and limiting its sale to adults only.
"Finally, proof of compliance with safety and quality standards should be made mandatory for the manufacturers and retailers to ensure availability of safe products in the market," the letter said.
They said that similar regulations and approaches to testing and quality controls are also needed for chewing (non-smoking) tobacco and pan masala products, thus minimising addicted users' exposure to toxicants.
They brought forth the issue since a report on e-cigarette will be discussed at the ongoing 7th Conference of Parties (CoP7) of the World Health Organization's Framework Convention for Tobacco Control (WHO-FCTC), which India is hosting for the first time.
"India is strongly positioned to be a global leader in tobacco control by investing in research on smoking cessation approaches, and provide the rest of the world with a road map on tobacco control leadership.
"We sincerely hope through you, a professional of standing yourself, that the Indian delegation led by you at the CoP7 shall offer that vision to the WHO-FCTC," it said.
They said that India is severely affected by an epidemic of tobacco-associated cancers due to the use of a variety of addictive tobacco products -- cigarettes, bidis, hukkas, gutkha, etc., and their equally dangerous alternatives containing areca nut -- pan masala.
"Currently, smoking cessation support in India is minimal with little or no efforts to develop proper communication strategy to achieve a significant decline in smoking population. On the other hand, a sound strategy in the Western world is showing positive results in terms of significant decline in tobacco-smoking," the letter said.
They said that cessation in the use of harmful tobacco products can be achieved in India with a combination of approaches since our country has huge diversity of cultures and traditions.
"In India, we need to apply, as a policy, nicotine replacement therapy supported by advocacy and where possible, psychological support, for it to work effectively.
"Among NRTs, nicotine gums, patches, inhalators, etc. have been in use for a long time but the outcome has been very limited. Therefore, WHO is now recommending even chronic NRT usage," it added.