There are two central arguments made in favour of the ban on e-cigarettes. The first is that it targets adolescents, and evidence suggest this to be true. E-cigarettes are being sold in various flavours, and being advertised as a safe alternative to smoking tobacco. This is unfortunate as decades of work done in the field of discouraging smoking are bearing fruit, especially in developed nations, and e-cigarettes have the potential to negate all such efforts.
A recent study revealed that 9 per cent of eighth graders and 25 per cent of 12th graders in the US had vaped last month (the corresponding prevalence in 2017 was 3.5 and 11 per cent, respectively). Studies have also indicated that a significant proportion of adolescents who vape will eventually switch to smoking tobacco. Vaping thus has the potential of being a gateway drug—the absence of which may have prevented an individual from smoking. Not being confident of enforcing a regulation on the sale of e-cigarettes to minors, the government's ban is a step in the right direction.
The second argument revolves around the safety of e-cigarettes. Emerging data suggest that e-cigarettes potentially blunt the defence mechanisms in the lung, cause certain biochemical reactions in lung tissue—that are akin to those caused by cigarettes—and contain volatile organic compounds that could potentially be carcinogenic.
There is an epidemic of vaping-associated deaths and ICU admissions that is presently being investigated in the US. However, the initial data suggest that these were caused by street-made and modified products (including those spiked with cannabis), and blaming all e-cigarettes in this instance might be analogous to blaming all alcohol sold for the ill-effects of spurious liquor. While most experts agree that it is premature to endorse the safety of e-cigarettes, none would consider them as dangerous as smoking tobacco. There is a consensus that switching to e-cigarettes is a harm-reduction strategy for individuals addicted to nicotine from cigarettes. Depriving them of such a strategy, while the sale of cigarettes continues unfettered is paradoxical.
I run a clinic that helps individuals quit smoking. Most individuals are self-referred, and have had multiple quit attempts before consulting me, highlighting the power that nicotine addiction has over individuals. We now have medicines and strategies that can help individuals quit, but most individuals who smoke do not have access to such services.
The move to ban e-cigarettes is welcome, but it needs to be coupled with services that help individuals quit smoking. This is especially true for adults who have successfully quit smoking with the aid of e-cigarettes. Without any support, they will be thrown back into a world where their only access to a substance they are addicted to is through the route of smoking or chewing tobacco.