Vaping is often seen as an alternative to traditional cigarettes, especially for those with lung conditions such as COPD, as it is thought to be less harmful. There is, however, insufficient research available on the effects of vaping for people with COPD.
This week in the US, the Trump administration signalled a crackdown on e-cigarettes, as the recently-surfaced nicotine epidemic has resulted in six deaths so far, and over 400 being diagnosed with vaping-related lung ailments.
With healthcare practitioners, civil society groups, and legislators demanding urgent action, the US Food and Drug Authority (FDA) is under pressure to roll out stricter regulations to curb the spread of e-cigarettes; especially among minors — a demographic group that has been significantly affected.
The Control of Tobacco and Electric Delivery Systems Bill targets the decline of local smoking habits. Among the proposed changes:
- Tobacco brands would need to be hidden from customers’ view and in plain packages.
- Indoor smoking would be prohibited.
- Cigarette smoking would be completely banned.
- Designated vaping areas would be created.
- A ban within 10 meters of a public building, in part, to protect individuals from second-hand smoke.
More steps in South Africa
In November 2017, South Africa’s National Council Against Smoking lobbied to expand the Tobacco Act and include e-cigarettes.
“We agree the (act) should be amended because there is evidence that it harms,” National Council Against Smoking Executive Director Savera Kalideen was quoted as saying. “It is not covered under the law because there were not e-cigarettes or vaping when the law was passed.”
WTF: Vaping is the act of inhaling and exhaling vapours of nicotine mixed in a liquid medium through a personal vapouriser that is delivered through a battery operated e-cigarette.
ALSO READ: Can vaping cause lung problems? click here to find out
Dr Konstantin Farsalinos, MD, Research fellow at the Onassis Cardiac Surgery Centre, Athens, who has done research on the subject and is teaching at the University of Patra, Greece and at the National School of Public Health, Greece, is a strong supporter of vaping as a solution towards smoke addiction reduction.
Target set by UAE to bring down male smokers from current 19% by 2021
Speaking to Gulf News from Athens, he said: “I welcome the UAE government’s decision to lift the ban as it is evidence and research-based.
“Eventually, cessation of smoking is the objective. But there are three lines, or methods, to reach this. The first option is to quit smoking without any aid, which only 5 per cent of smokers achieve; the second is to use aids like patches, gums lozenges or prescription medication which research has shown achieves success in only 20-25 per cent of smokers. The quit rates are disappointing. Smokers need a third line or option to slowly help them wean off the habit. Introducing [vaping] option to the UAE residents might help the cause of smoking de-addiction,” said Dr Farsalinos.
India set to ban e-cigarettes
According to a report by the Press Trust of India, The Drugs Technical Advisory Board of India has approved a proposal to regulate Electronic Nicotine Delivery Systems (or ENDS) by classifying them as “drugs” and cancelling them from being sold in the country. Under Sections 26A and 10A of the Drugs and Cosmetics Act, 1940, this proposal plans to prohibit the sale, manufacture, import and distribution of all ENDS.
The proposal states that, “After revisiting its earlier deliberations, the Drugs Consultative Committee has recommended that since ENDS and related products are used as a tobacco cessation product and function for nicotine delivery, these devices fall under the definition of ‘drug’ as defined under Section 3(b) of the Drugs and Cosmetics Act, 1940.”
This move comes highly recommended by the Indian Council of Medical Research (ICMR) that has recommended a “complete ban” on ENDS, saying such devices become a gateway to smoking and can get a non-smoker addicted to nicotine. 12 states, from Maharashtra to Karnataka to Himachal Pradesh, have already banned their sale months ago, while Haryana and Odisha plan to hop onto the ban-wagon.
Here’s a look at the US government’s policy on vaping products so far:
*What are e-cigarettes, the epidemic they have caused?*
E-cigarettes, also called ‘vapes’ or ‘electronic nicotine delivery systems (ENDS)’, are battery-run devices that were originally marketed as a safer alternative to smoking traditional cigarettes. In recent years, there has been a deadly rise in nicotine addiction in the US, allegedly due to aggressive marketing by manufacturers.
Minors have been particularly affected, with a 2018 survey showing that as many one in five and one in 20 students going to high school and middle school respectively using e-cigarettes.
The disease caused by vaping — suspected to be behind at least six deaths — is unknown to doctors, and a link between vaping and the lung illness is yet to be concretely established. Symptoms, according to the Centers for Disease Control and Prevention (CDC), are those in common with other respiratory illnesses, including coughing, chest tightness, shortness of breath, extreme fever or fatigue.
*Deemed as tobacco products in 2016*
The FDA in 2016 categorised e-cigarettes as a ‘tobacco product’, expanding its authority to regulate the product’s sale. Following this decision, a ban was placed on distributing free samples of e-cigarettes and their sale through vending machines. Importantly, it was provided that new vaping products could enter the market only after obtaining a premarket review clearance from the FDA. However, the products having ‘grandfather status’, meaning those introduced before February 15, 2017, were excluded from the clearance requirement.
While the FDA widened its mandate to control e-cigarette sales, the agency stopped short of taking a tougher stance, such as banning some of the varieties of the product.
*2017 compliance policy*
In a policy decision announced in July 2017, the FDA tried to give some relief from regulations to manufacturers. It was believed that this would spur innovation for new products that could help reduce the nicotine addiction rate in the US, which at the time was already levelling off. The FDA thus kept extending the enforcement deadline of the 2016 deeming rule.
*2019 draft guidance*
In the period since the 2017 policy, a marked increase in vaping-related illnesses was reported, and studies revealed the phenomenal rise in addiction among youth. The availability of vapes in flavours such as fruit, candy, and chocolate was purported to be among the reasons for the product’s popularity.
Thus, in March 2019, the FDA issued a draft guidance, the precursor to a new policy, seeking to adopt a tougher stance on e-cigarettes, especially the flavoured variants. Except for tobacco, menthol, and mint flavours, the draft guidance sought to enforce the premarket review deadline for all e-cigarettes immediately.
*What could happen now*
With political pressure increasing, the Trump administration could roll out even tougher rules. Juul, the market leader in the US e-cigarette industry, is already under the FDA’s scanner for its allegedly youth-targeted aggressive marketing campaign.
This month, the state of Michigan banned flavoured e-cigarettes entirely, and more US states could follow the example. The federal government too could take such a decision, thus going beyond the March 2019 draft guidance recommendations.
ALSO READ: Can vaping cause lung problems? click here to find out