E-cigarettes: A ticking health time bomb in India

Hyderabad: India has banned e-cigarettes to protect the public from vaping-related harm. Despite the ban, educated young people appear to be addicted to e-cigarettes.

A recent study conducted by The George Institute for Global Health (GIGH) has found usage of e-cigarettes continues to be a public health challenge in India. Despite its ban in the country, the study reveals that educated young people are most addicted to e-cigarettes.

Banned In India

In India, e-cigarettes are banned as per law. Production, manufacture, import, export, transport, sale, distribution, storage, and advertisement of e-cigarettes, e-nicotine flavored hookahs, electronic Nicotine Delivery Systems (ENDS) such as vapes, etc are offences punishable under the Cigarettes and Other Tobacco Products Act (COTP) because all these products are dangerous for public health. The penalty involves a fine of up to Rs five lakh and imprisonment of up to three years.

Purpose of the study

The study aimed to examine educated young adults’ e-cigarette-related attitudes and behaviors and their support for various e-cigarette control policies.

A total of 840 tertiary-educated young adults completed an online survey. Demographic characteristics, e-cigarette, and tobacco use, beliefs about e-cigarettes, exposure to e-cigarette advertising, sources of access to e-cigarettes, numbers of family members and peers who vape, and support for a range of e-cigarette policies were assessed.

The results have been published in the Journal of Preventive Medicine reports. The study was conducted by Dr. Simone Pettigrew, Dr. Joseph Alvin Santos, Dr. Mia Miller, Dr. Min Jun, Dr. Georgia Morelli, Dr. Alexandra Jones from The George Institute for Global Health, University of New South Wales, Sydney, and Prof. T Sudhir Raj, a research fellow from the George Institute for Global Health, New Delhi.

Key findings

One-third reported never having heard of e-cigarettes/vapes, 23 % reported ever using e-cigarettes, 70 % reported ever using tobacco, and 8 % were dual users of both e-cigarettes and tobacco. Only 8 % of e-cigarette users reported daily use. Vapers sourced e-cigarettes from retail outlets (vape shops, tobacconists) and their social networks (friends, siblings).

Just under two-thirds of those who were aware of e-cigarettes believed them to be harmful and to contain chemicals. Among non-users, 31% were curious about using e-cigarettes, and 23% intended to use them in the following year, indicating high levels of susceptibility.

Prevalence despite a ban on e-cigarettes

The results of the study suggest that despite a complete ban, young people are still able to access e-cigarettes in India. Greater education about harms associated with vaping and more intensive monitoring and enforcement could assist in reducing uptake in relatively high-prevalence groups such as educated young adults.

“E-cigarettes are available to young people. These are being promoted despite the ban in India. Those with higher levels of education are among the most vulnerable to future e-cigarette use,” says Dr. Simone Pettigrew, head of Food Policy, GIGH.

“The most commonly reported reason for using e-cigarettes was ‘A friend used them, informed Dr. Sudhir Raj. Exposure to vaping within the family and peer groups is a conduit through which vaping rates will increase over time. Intense monitoring and enforcement of existing regulations would assist in preventing greater uptake in the future, say the researchers.

Harmful effects of vaping/e-cigarettes

E-cigarettes heat liquid chemicals and produce aerosol vapors, which contain various harmful and toxic carcinogenic substances, nicotine, heavy metals, harmful flavoring chemicals, ultrafine particles, and volatile organic compounds.

Increased risk of various cardiac ailments

Higher risk of brain stroke

Damage to the blood vessels and walls of arteries

Coughing and difficulty in breathing

Vaping lung injury and acute damage to the lungs

Nausea, vomiting, and diarrhea