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    What is ENDS?

    • Electronic Nicotine Delivery Systems and Electronic Non-Nicotine Delivery Systems (ENDS / ENNDS) have the potential to be a new form of nicotine addiction.
    • The liquid in these battery-powered devices typically contains nicotine, propylene glycol, glycerin, flavourings, and other harmful chemicals.
    • Fruit and candy flavours such as chocolate, strawberry, and vanilla are added to the liquid to make it attractive for kids/teenagers.

    FACTS:

      • Use of E-Cigarettes is considered unsafe. Nicotine present in E-Cigarettes is a highly addictive drug with known health risks.
      • E-Cigarettes can contain cancer-causing chemicals and heavy metals that are inhaled into the lungs.
      • Use of E-Cigarettes increases the possibility of using multiple tobacco products.
      • Nicotine and other chemicals in E-Cigarettes can harm the developing brain and can also cause addiction.
      • E-Cigarettes are marketed as an alternative to smoking traditional cigarettes. Instead, the e-cigarette epidemic can create a new generation of first-time tobacco users.
      • Nicotine present in E-Cigarettes may lead to youngsters taking up conventional cigarettes.
      • Nicotine consumed during adolescence can harm the development of the brain, alter nerve functioning, and has risks of seizure.
      • Increase the likelihood of former smokers to again become addicted to nicotine through E-Cigarettes.

    Know the risks

    Nicotine addiction and brain development

    • The developing teen brain is more vulnerable to addiction through the use of E-Cigarettes.
    • Brain development continues till mid-20s, so nicotine addiction can harm adolescent brain development.
    • It can harm parts of brain that control attention, learning, mood, and impulse control.
    • Risk for future addiction.

    Second-hand smoke

    • E-cigarette aerosols can contain a mixture of elements, including heavy metals, some with concentrations higher than in conventional cigarette smoke.
    • The aerosol that users breathe from the device, including second-hand smoke can contain ultrafine particle, flavoring such as diacetyl, a chemical linked to a serious lung disease.
    • Use of E-Cigarettes around pregnant women can expose the developing fetus at risk.

    Explosions and exposure

    • There are numerous reports about explosions in defective E-Cigarettes, some of which have resulted in serious injuries.
    • These explosions typically take place during charging, or by overheating of the device leading to battery failures.
    • Accidental exposure to or ingestion of e-liquids can be very dangerous and, in the case of accidental swallowing or injection, even fatal.

    Indian context

    Increased tobacco burden

    • There are almost 267 million tobacco users in India. ENDS will add to growing menace.
    • India has the highest burden of tobacco related diseases. Since ENDS is not a completely safe product, it may add to the increasing list of diseases burden.
    • The economic cost of smoking is in millions. Exposure to ENDS may have a widespread economic impact.
    • Introducing ENDS may hold ongoing tobacco control efforts in India.

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    ICMR calls for a complete ban

    • India Council of Medical Research (ICMR) recommends complete ban on e-cigarettes and other electronic nicotine delivery systems as its use can introduce or lead to nicotine addiction among non-smokers
    • E-cigarettes have adverse impact damaging cardiovascular system, impairs respiratory immune cell function and severe respiratory disease
    • Cases of poisoning and accidental swallowing by children have been reported by ICMR

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    Progress in states

    • States that have banned e-cigarettes.

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    Research papers

    White Paper on Electronic Nicotine Delivery System (ENDS)

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    Surgeon General’s Report on E-cigarette Use Among Youth and Young Adults

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    Acute Effects of Electronic Cigarette Aerosol Inhalation on Vascular Function Detected at Quantitative MRI

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    E-cigarettes, Hookah Pens and Vapes: Adolescent and Young Adult Perceptions of Electronic Nicotine Delivery Systems: Table 1. Nicotine & Tobacco Research

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    A Content Analysis of Vaping Advertisements on Twitter, November 2014

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    Exposure to Advertisements and Electronic Cigarette Use Among US Middle and High School Students

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    Receptivity to E-cigarette Marketing, Harm Perceptions, and E-cigarette Use. American Journal of Health Behavior

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    Trends in E-Cigarette Awareness and Perceived Harmfulness in the U.S. American Journal of Preventive Medicine

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    Association Between Electronic Cigarette Marketing Near Schools and E-cigarette Use Among Youth. Journal of Adolescent Health

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    Comparing young adults to older adults in e-cigarette perceptions and motivations for use: implications for health communication: Table I. Health Education Research

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    New cigarette brands with flavors that appeal to youth: tobacco marketing strategies. Health Aff (Millwood)

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    Electronic cigarettes: human health effects.

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    Preferred flavors and reasons for e-cigarette use and discontinued use among never, current, and former smokers. International Journal of Public Health.

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    A content analysis of Twitter. Addictive Behaviors Reports on Twitter, November 2014

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      Facts About Tobacco

      Under Article 11 of the World Health Organization’s Framework Convention on Tobacco Control (FCTC), parties are required to implement packaging and labelling that effectively communicates – to both current tobacco smokers and to non-smokers and youth – the health risks associated with tobacco use. India is a party to the FCTC.

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