Cancer surgeon Dr Pankaj Chaturvedi who is also one of the nation’s most vocal anti-tobacco campaigners tells us why electronic cigarettes are very hazardous.
Electronic cigarettes are being
increasingly used by youngsters as a safer alternative to regular
tobacco cigarettes (though they were recently banned in Maharashtra and
Punjan). It’s available in malls and online stores and was even endorsed
by Bollywood star Sonam Kapoor as a safe alternative to regular
cigarettes. The marketing campaign to promote e-cigarettes is slick and
clever and is targeting the youth of metros and this is bound to have
huge health repercussions. We’ve still not recognised the threat
e-cigarettes pose and haven’t realised that it is going to become a big
public health issue. Here are some things you didn’t know about
electronic cigarettes:
What is an e-cigarettes?
An e-cigarette is nicotine
containing electrical device that mimics the act of tobacco smoking by
producing hot vapour and often the flavour of smoke. The device uses
heat to vaporise a glycerine-based liquid solution. The device is
primarily meant to deliver pure nicotine and sold as an alternative to
cigarettes. Nicotine comes under category of ‘drugs’ and need to be
marketed appropriately.
How harmful is nicotine?
Tobacco has got two major harmful
ingredients – cancer causing chemicals (nitrosamines, hydrocarbons etc)
and nicotine. Nicotine is a highly addictive and noxious substance. Even
a small dosage of nicotine has been found to be fatal for life. It is a
cardiac stimulant, causes severe psychological disturbances and shown
to have cancer causing effect in animals. Because of these serious
side-effects, Food Safety Standard Act of India 2006 section 2.3.4
prohibits addition of nicotine to any food substance.
Where is the evidence that nicotine replacement is beneficial?
Researchers believed that offering
purified nicotine, after removing cancer causing chemicals, will be a
safer alternative to ‘whole’ tobacco. However, several well-conducted
studies have proved that the philosophy of ‘nicotine replacement
therapy’ has not made any dramatic impact. A recent randomised trial
showed addition of Nicotine replacement therapy to smoking pregnant
women did not improve cessation. To be precise, currently there is no
affordable and effective drug to help smokers quit.
What is the difference between e-cigarettes and nicotine replacement therapy?
Nicotine replacement therapy (NRT)
is offered under medical supervision for a defined period at defined
point of attempted quitting. However, usage of e-cigarettes completely
lacks any medical supervision and is freely available to unsuspecting
patrons mainly youth! This lack of trade restriction makes e-cigs major
public health hazard that is worse than tobacco.
What is the status of e-cigs in other parts of world?
Since 2008, the US FDA has been
stopping shipments of e-cigarettes from entering the country and Canada
fully banned the devices in March 2009. The US FDA issued a warning on
22nd July 2009 not to use electronic cigarettes.
What are the analysis results of e-cigs by USFDA?
USFDA has tested two of the devices:
the Smoking Everywhere and Njoy products and found them harmful. At a
news conference, FDA analyst Benjamin Westenberger described testing 19
cartridges from the two e-cigarettes at the FDA’s St. Louis facility.
Among the findings:
- All but one cartridge marked as having no nicotine actually contained the addictive substance.
- Cartridges marked as having low, medium, or high amounts of nicotine actually had varying amounts of nicotine.
- One of the cartridges contained a toxic antifreeze ingredient, di-ethylene glycol.
- The devices emitted tobacco-specific nitrosamines which are human carcinogens.
- The devices emitted tobacco-specific impurities suspected of being harmful to humans.
How are e-cigs advertised and marketed?
E-cigarette makers and distributors
argue that e-cigs are safer than cigarettes. Some have presented
anecdotal never-proven case studies to claim that their products have
helped people quit smoking. However, no well-conducted study has ever
proven that e-cigs help people quit or they are safe. The synthetic
nicotine in the e-cigs is clearly a harmful substance and sale of such
products need to be strictly regulated.
Are there any nicotine-free e-cigs?
Though there are nicotine-free
versions available, hardly any one buys it. E-cigarettes and similar
products are sold online and in scores of mall kiosks across India.
Non-Nicotine E-cigs have a clear potential to entice new smokers with
their fruit and candy flavours.
The views expressed are Dr Chaturvedi’s, theHealthSite doesn’t necessarily endorse those views.
Dr Chaturvedi is a Professor and
Head Neck Surgeon at Tata Memorial Hospital, a tertiary cancer centre
under Department of Atomic Energy, Government of India. He is the co
author of the Text Book of Head Neck Surgery, Editor of the
International Journal of Head Neck Surgery and published more than 100
papers in peer reviewed journals. He is an accomplished researcher and
received Robert Maxwell Byers Award from the American Head Neck Society
in 2010. He has been invited as visiting faculty in 22 institutions in
16 countries. He is very active in the field of tobacco control and
founded the popular ‘Voice of Tobacco Victims” campaign that played
pivotal role in nationwide ban on Gutka. For his contribution in public
health, he has received Outstanding Young Indian Award, WHO Director
General Award and Judy Wilkenfield award. He was also nominated as the
Global Cancer Ambassador by American Cancer Society. He was among the 5
civil society representatives who spoke on tobacco control in special
summit of United Nations in 2011.