Recently a research report on e-cigarettes was published by Simone Pettigrew et. al. from the George Institute for Global Health, University of New South Wales, Sydney, Australia. The authors studied the factors contributing to young people’s susceptibility to e-cigarettes in four countries (Australia, China, India, and the United Kingdom).
The factors include demographic characteristics, e-cigarette, and tobacco use, exposure to e-cigarette advertising, and number of friends and family members who vape. Those who had never used e-cigarettes were also assessed for susceptibility (curiosity about e-cigarettes, intentions to use in the next 12 months, and likely use if offered by a friend). The research findings were published in the journal Drug and Alcohol Dependence.
The results were astonishing. Although India is one of the few countries that has completely banned the sale of e-cigarettes, the results revealed that 61% of young people from India who never used e-cigarettes are susceptible to vaping e-cigarettes. The results are comparable with the U.K., where it is 62%. Whereas China had the high numbers (82%) and Australia had the fewer numbers (54%) when compared to India.
The factors associated with susceptibility were identified as: tobacco use, exposure to advertising, higher income, and having friends and family members who vape. Factors that had a negative association with susceptibility were perceptions of harmfulness and education.
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The concept of e-cigarettes serving as a gateway to smoking traditional cigarettes has been a topic of debate among researchers and public health experts. It was initially recommended as a smoking cessation device by the manufacturers; however, there are no proven results to say it is an effective tool to quit smoking. E-cigarettes are not approved by the FDA as a smoking cessation aid.
It was argued that the e-cigarette aerosol contains fewer toxic chemicals than the deadly mix of 7,000 chemicals in smoke from regular cigarettes, and therefore, this could be a potential harm reduction strategy. However, the harmful effects of e-cigarette aerosol cannot be outweighed. It is reported to contain harmful and potentially harmful substances, including nicotine, heavy metals like lead, volatile organic compounds, and cancer-causing agents (CDC). Therefore, it’s still not the safer alternative.
In a study by CDC, it was found that many adults use e-cigarettes in an attempt to quit smoking. However, most adult e-cigarette users do not stop smoking cigarettes and are instead continuing to use both products (“dual use”).
The aerosol is produced in the E-cigarettes by heating a liquid that contains nicotine—the addictive drug in regular cigarettes, cigars, and other tobacco products—flavourings, and other chemicals help to make the aerosol. Not only do users inhale this aerosol into their lungs, but the bystanders also breathe in this aerosol when the user exhales into the air (Center for Disease Control and Prevention). The ultrafine particles can be inhaled deep into the lungs. The flavours, such as diacetyl, is a chemical linked to serious lung disease.
The nicotine in the e-cigarettes is addictive and toxic to developing foetuses. Nicotine exposure can also harm adolescent and young adult brain development, which continues into the early to mid-20s.
Adolescents are the soft targets for the industries. The designs and flavours are specially made to attract youth. E-liquids come in a wide range of flavours, including fruit, candy, menthol, and tobacco. A plethora of evidence showed that the devices were causing a new form of nicotine addiction even among non-smokers.
Although a few countries banned its sale or restricted its use, others have brought regulations to control aspects such as advertising, packaging, and nicotine content. Despite the ban, restrictions and regulations, the online marketing and sale must be controlled by the regulatory authorities.
While India is still struggling to restrict smoking and implement the ban on gutkha, the findings of Simone Pettigrew are of great concern today. It is crucial that the government and other stakeholders take stringent measures to protect youth from the harmful effects of e-cigarettes.
Stricter regulations should be put in place to prevent marketing and advertising. It is mandatory for the regulatory authorities to collaborate with online platforms and marketplaces to implement and enforce policies that prohibit the sale of e-cigarettes to underage individuals. Robust monitoring systems to identify online platforms and websites that sell e-cigarettes should be in place to help regulatory authorities to take prompt action.
As of today, 47 countries have banned e-cigarettes, the latest one being Australia.
Public health experts have been crying out for decades that tobacco in any form kills. It is time to wake up to protect the next generation, from even milder forms of tobacco use.
(The author is director, Fenivi Research Solutions and has anchored tobacco cessation training programmes)
Published - July 03, 2023 09:02 pm IST
