Indian Medical Association condemns the use of Electronic Cigarettes as a way to reduce the number of smokers in the country
New Delhi, January 13, 2015: Electronic cigarettes (e-cigarettes) have been touted as a sure fire way to reduce the negative health impacts of smoking, while still delivering nicotine to people accustomed to daily doses. Still, in comparison with available US FDA approved pharmaceutical therapeutics, the safety and efficacy of e-cigarettes as tools to quit smoking are unknown. The Indian Medical Association does not support the use of e-cigarettes and believes that there are many other ways through which individuals can be encouraged to quit smoking
E-cigarettes, invented in China in 2003, has seen a marked increase in global usage since 2010, typically targeting younger, high income, and more educated brackets of society. These e-cigarettes mimic the size and shape of cigarettes and contain a cartridge containing liquid, which includes nicotine (up to 36 mg/ML) amongst other chemicals (usually propylene glycol or glycerol).
Metals such as chromium, nickel, tin, and lead have been found in e-cigarette liquids/vapors amongst other compounds such as phenolic compounds, and volatile organic compounds. Still, constituents of cigarette smoke (carbon monoxide, oxidant gases, and tars for example) are absent in e-cigarettes.
While believed overall to be likely less harmful than cigarette smoke, evidence is not definitive. When heated and aerosolized, the overall safety of propylene glycol (producing the toxin, acrolein) or glycerol is unknown, with fears that propylene glycol may decompose at high temperatures producing propylene oxide. Both of these agents decompose to form carcinogens acetaldehyde and formaldehyde, depending of the batter voltage used in the e-cigarette. Further fluid ingestion could lead to consumption of a dosage of 20-100 mg/ml (in a typical 5 mL vial), against a lethal dose of nicotine of 10 mg in children. While less toxic, second hand smoke also includes serum cotinine, in comparable amounts to cigarette smoke exposure.
Commenting on this, Dr. S.S Agarwal – National President and Padma Shri Awardee Dr. KK Aggarwal – Honorary Secretary General of IMA in a joint statement said, ”The Indian Medical Association believes that e-cigarettes though not as harmful as normal cigarettes are not healthy and their use should not be encouraged. Like hookah’s, they are disguised forms of tobacco addiction and can have serious long-term effects on one’s health. Cigarette smoking and tobacco chewing are one of the leading causes death around the world. The medical fraternity must together raise awareness about making our country smoke free.”
E-cigarettes have been banned in Uruguay, Brazil, Singapore, and Canada – all fairly progressive countries. A WHO report suggested that regulations were needed to stop promotion to non-smokers, and the US FDA refuses to regulate e-cigarettes. These points should be noted by physicians when suggesting alternatives to their patients.