Why India’s e-cigarette ban will do more harm than good
In September 2019, the government announced a complete ban on electronic cigarettes under the pretext of preventing potential health risks for young Indians. In what can now be described as typical, this decision was passed in the form of an ordinance, without debate or deliberation in parliament and largely ignoring both the evidence regarding the health risks and the lessons learned from multiple experiences. India’s previous disastrous bans. About a year and a half and a pandemic later, it’s time to reconsider the (de) merits of the ban and possible ways forward.
In the absence of data and evidence from India, it would be instructive to examine two policy approaches followed elsewhere in the world and seek to draw meaningful lessons for India’s next steps.
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Abstinence and harm reduction
When people engage in risky and dangerous behaviors (especially victimless activities), the government can take one of two approaches: abstinence or harm reduction; ban or regulation. Abstinence implies a paternalistic attitude, emphasizing risky behaviors and radically modifying the incentives to stop them.
This can include prohibitions with severe penalties for violations or the imposition of high taxes on sin. This approach may seem like the right decision in many cases, when the harms are clearly identified, such as smoking or excessive alcohol consumption. However, as countless evidence shows, it rarely works.
The other approach is to recognize that some people will always engage in risky behaviors and that the government has little control over how people behave. However, the aim is to reduce the damage by offering less risky alternatives. Examples of such harm reduction policies are regulating the alcohol content in beverages, providing sex education and condoms to adolescents, or even requiring the use of helmets on motorcycles to reduce harm. damage in the event of an accident, instead of completely banning motorcycles.
The United States (United States) and United Kingdom (United Kingdom) have adopted two contrasting approaches to ENDS or electronic nicotine delivery systems with markedly different results. The United States has had a troubled history with ENDS with many political shifts, which have had dire consequences in society.
The UK, for its part, has encouraged the use of ENDS as an alternative to much more dangerous traditional cigarettes. It is truly the story of two contrasting public policy initiatives with valuable lessons for India.
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The Food and Drug Administration (FDA) in the United States initially classified e-cigarettes as drug delivery systems and therefore classified them as illegal. A court case later, they were reclassified as tobacco products, which still have severe restrictions on promotions and advertisements. Importantly, since the FDA classified e-cigarettes as being no different from normal cigarettes, they could not be promoted as smoking cessation tools.
This political approach has important implications for society. The initial growth in the number of vapers was largely attributed to smokers trying to quit. However, with these policy changes, when e-cigarette companies could no longer market their products as safer alternatives to adult smokers, a new demographic was discovered.
The delicious flavors of electronic cigarettes, such as blueberry, mint or mango, were especially appealing to the younger generation.
There was also the issue of state capacity and regulation, or lack thereof. The United States resorted to blunt instruments such as marketing bans and restrictions, but did not focus on product quality, nicotine content, flavors, etc.
The original ban and lack of regulation meant that young people did not stop at vaping nicotine alone – nicotine dissolved in water was replaced with marijuana dissolved in oils, resulting in deaths in the United States.
The UK preferred to view e-cigarettes as safer alternatives to regular cigarettes and there is sufficient evidence to show this approach is correct. Nicotine is far from harmless – it’s an extremely addictive substance that can harm the heart, respiratory, and circulatory systems, among others – but it’s certainly not the most harmful substance in a cigarette.
Regular cigarettes deliver 7,000 other chemicals (arsenic, benzene, ammonia, lead, etc.) to your lungs along with nicotine, and this is where the greatest danger lies. E-cigarettes or extremities remove all other chemicals.
Unlike the United States, the United Kingdom has taken a proactive approach to regulating ENDS. It limited the nicotine content (20 milligrams per milliliter of nicotine in e-liquids). Such a limit does not exist in the United States, where it is not uncommon to find up to 54 milligrams per milliliter, which explains the much higher levels of dependence among young people on these products in the United States. There are also restrictions on adding other additives to the e-cigarette liquid (like caffeine, taurine, etc.).
Advertisements for these products are not limited. The UK’s approach has led to better overall results – smoking among adults and young people continues to decline, and e-cigarettes have become the most popular aid to quit smoking. Underage vaping is almost non-existent in Britain, compared to the United States.
Read also: Government proposes to raise legal smoking age to 21 and ban bulk cigarettes
Way forward for India
India has chosen an even stricter option than the United States of banning the product altogether, while inexplicably having no additional restrictions on traditional cigarettes, which have been shown to be several times more harmful (long-term harm to consumers). electronic cigarettes is less than 5% compared to other tobacco products).
As with any other ban in India – be it single-use plastic, alcohol, or pornography – the market always finds a way. There are thriving underground or black markets for all of these government banned substances and it is no different with e-cigarettes. People can buy e-cigarettes online quite easily on a variety of portals, including Instagram, as one report suggests.
The problem with sending these products underground is that the government loses any form of control over the product. If a seller is selling an illegal product anyway, what difference would the buyer’s age make – whether over or under 18? Also, since it is illegal, would it make sense for a seller to guarantee the quality and safety of the product? There are many reports of substandard and potentially dangerous products being sold in India on the black market.
It would be up to the government to learn from the lessons of the UK and the US and choose a harm reduction approach, which would involve developing a regulatory plan for e-cigarettes that maximizes smoking cessation. among adults while limiting adoption by young people.
In addition, the regulatory plan may include levying appropriate taxes, issuing guidelines for public use, providing product information, enforcing a minimum age for sales, and restricting individual products. regarding flavor choices and nicotine concentration in electronic cigarette products. In this way, broader public health goals can be achieved much more effectively.
(The author is an assistant professor of economics at the Takshashila Institution, a think tank and school of public policy.)