120 MILLIONS TOBACOO USERS & 2 LACS / YEAR CANCERS OF HEAD & NECK INDIA NEED HARM REDUCTIO AS "ENDS"

120 MILLIONS TOBACOO USERS & 2 LACS / YEAR CANCERS OF HEAD & NECK INDIA NEED HARM REDUCTIO AS "ENDS"

Prof.Dr.Dram,profdrram@gmail.com,Gastro Intestinal,Liver Hiv,Hepatitis and sex diseases expert 7838059592,943414355    www.blogspot.com/drnakipuria     www.bhartiyanews24x7.com    www.bhartiyanews24x7.net

        Tobacco smoking is one of the world’s and India’s biggest and most preventable cause of early death and a blight on culture and society. With 120 million tobacco smokers, India is the second largest consumer of combustion-based tobacco products globally and witnesses over one million deaths per year due to tobacco related illness.Nearly 2 lac Head & Neck cancers are diagnosed yearly out of which 80000 are of oral cavity exposed to some form of tobacco.57% of all head & Neck cancers occurs in India and 60-80% are of advanced stage and constitute 30% of all cancers in india. Despite efforts to reduce tobacco burden by means of taxation, stringent labelling requirements, etc.,Cigarette,Bidi,Cigars volumes have not witnessed significant decline in India as Tobacco industry will never be closed as being very rich so have got clout with politicians,bureaucrats, judges etc.

  So a pathy way should be chosen as Bidi,Cigarette cessation,but if complete ban is not possible then we should choose a path so that we can consume it with very less toxicity as complete cessation result in withdrawl symptoms hard to practice as reccurrence to smoking again happen.So  Electronic Nicotine Delivery System (ENDS) are reduced harm alternatives that have helped many smokers fulfill their nicotine carving, without exposure to toxic by-products.It is encouraging to see an increasing debate around ENDS as we review this as an option to potentially address the public health catastrophe. After all, the substitution of less harmful goods and services has long played a key role in improving and extending lives. Now is the time to have a real conversation to understand the benefits and expel the myths around ENDS and vaping.

Knowing where the damage comes from during the act of smoking helps us understand the relative benefits of vaping. The reality here is that what kills people is the smoke. As we know from cooking over unventilated open fires or breathing highly polluted air, the products of combustion are deadly. With cigarette smoking the level of directly inhaled toxins from the combustion process is extraordinary. It is the tar that is generated as a result of combustion that’s the deadliest. Cigarettes are likely in the range of 20 to 100 times more hazardous than already existing non-combustible products like vaping. Taking combustion out of the process removes an overwhelming majority of the risks.

The UK, Sweden and Norway, along with many other countries, have long been aware of and have seen significant research on the negative health impact of cigarette smoking and have acted accordingly. But people there viewed the substitution of low risk alternative products as a means to help reduce the damage caused by combustible tobacco through thoughtful regulation. This is not merely theoretical. Sweden has achieved the lowest rates of smoking and of tobacco caused illness in Europe due to a low risk form of smokeless tobacco called snus. The UK is dramatically lowering cigarette use via the substitution of vaping. Japan has reduced cigarette sales by a third in just three years through product substitution. Working with market forces achieves more, far more quickly, than seeking an outright ban of safer alternatives to lethal cigarettes

Public Health England and other leading medical research institutions such as Royal College of Physicians recommends ENDS as an alternative for adult smokers because their research shows that it is likely to be at least 95% less harmful than traditional smoking. Even Cancer Research UK, which has an MoU with the Government of India has conducted rigorous research and concluded that vaping is far less harmful than smoking. They also mention that while vaping products contain nicotine, which is addictive, it doesn’t cause cancer contrary to popular perception.

There has been a concerted effort by opponents of vaping to denigrate such products. One particular area surrounds youth use of vaping products. The UK has been adept at thoughtfully regulating the use of ENDS to combat underage use. Only 1.7% of the UK population under the age of 18 uses e-cigarettes weekly, and more importantly, a vast majority of them were already regular cigarette smokers. For youth who never smoked in the UK, only 0.2% use e-cigarettes regularly.

My home country of Canada has also taken progressive steps to regulate rather than ban ENDS and make them an accessible option for smokers looking to quit. In May 2018, the Canadian government amended the Tobacco Act and Non-smokers’ Health Act to establish a new legislative framework to regulate the manufacture, sale, labelling and promotion of vape products, to enable people who smoke to switch to vaping, and to deter any unintended consequences.

 Recently, the UAE and Seychelles have also taken an informed decision to move from prohibition of ENDS to regulation of the category.So, we know vaping is significantly less harmful than smoking and we have many clear case studies that show effective regulation achieves huge societal gains. Regulation will also help the government manage pricing, advertising, marketing, promotion and the sale of ENDS in a manner where the greatest health gains can be achieved. A ban is naïve, protects far deadlier products, disempowers consumers and opens up a black market with unregulated pricing and low product standards while promoting criminality.

Therefore, it is important that the Government of India moves away from its current advisory and supports risk-proportionate regulation of this category. Regulation gives the government the ability to ensure that safeguards are there to manage how ENDS are sold and to whom, and most importantly that the government gives its citizens who smoke a legitimate option to choose for themselves.Speaking of cigarette cessation globally, there is sufficient evidence to prove that Electronic Nicotine Delivery System (ENDS) are reduced harm alternatives that have helped many smokers fulfill their nicotine craving, without exposure to toxic by-products.