An unfortunate trend to the radical regulation of e-cigarettes progressed further today as Reuters reports that the Indian government is considering a total ban on the products. We have written recently on the WHO’s flawed policy stance on e-cigarettes, which fed into a policy position from the 6th Conference of the Parties to the FCTC in Moscow in mid-October, leaving open the option of bans for the products. It is in this prohibitionist context that the proposed measures in India need to be viewed.
While smoking prevalence in India, because of the pervasive use of smokeless tobacco products is relatively low at 6.5%, the sheer size of the population means that there are 52 Indian million smokers, the 3rd largest global smoking population behind China and Indonesia. In total there are some 275 million tobacco consumers in India and the Indian government has been proactively seeking to control all forms of tobacco consumption in the country.
"No less unsafe"
The indications from Ministry of Health officials reported by Reuters are that it has decided that e-cigarettes represent a part of the problem, rather than part of the solution. Speaking at the 45th Union World Conference on Lung Health in Barcelona earlier this week the Indian Health Minister Dr Harsh Vardhan advocated a complete ban on e-cigarettes referencing research which found that “they are no less unsafe” than combustible cigarettes. This stance echoes comments attributed Dr Vinayak Mohan Prasad, Senior Adviser (who has responsibility for building capacity for tobacco control in Africa, according to the WHO website) by The Hindu newspaper in August 2014 referring to the ‘false impression that these devices (e-cigarettes) are not as harmful as regular cigarettes’.
It is not clear to which research Dr Vardhan was referring in his Barcelona speech and the concern regarding India’s apparent prohibitionist policy on e-cigarettes is that if it is based on a conviction that there is an equivalence in public health risk between cigarettes and e-cigarettes, then the policy in fact has no basis at all. Every available research on e-cigarettes (of which there is a substantial and growing body) indicates that the products are of several orders of magnitude less harmful than combustible tobacco use. Indeed, given e-cigarettes’ potential to appeal not only to Indian RMC smokers but also bidi and smokeless tobacco consumers one can’t help wondering whether a more open (but still cautious) approach to e-cigarettes might not be more beneficial to the Indian public health.
ITC's Eon brand launched in August 2014
The Indian market for e-cigarettes remains relatively small (something which perhaps in part contributes to confusion around the nature of the products), but as elsewhere is growing rapidly. The competitive landscape has been dominated by imported brands, marketing and distributing their products online to technologically aware urban Indian consumers. However, in August 2014 India’s largest tobacco company, ITC (which controlled 78% of the domestic cigarette market in 2013) launched its Eon branded e-cigarette product. The company engaged in a soft launch of the product in Kolkata and Hyderabad and plans to engage in a phased roll-out across India.
As with the WHO’s wider policy stance on e-cigarettes, it is not clear to what extent the involvement of a large tobacco company in the category and a fundamental objection to the consumption of nicotine itself is motivating the Indian government’s current apparent intentions but it would surely be unfortunate if the emphasis placed on either of these factors became self-defeating.