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Experts ask govt to regulate ENDS products clinically and legally towards oral cancer prevention

Shardul Nautiyal, Mumbai
Saturday, June 5, 2021, 08:00 Hrs  [IST]

Experts have recommended that governments should regulate electronic nicotine delivery systems (ENDS) products clinically, medically and legally not leaving it to free market towards oral cancer prevention.

They further recommend banning such products is the worst form of regulation and should be avoided.

In many age groups and states, half the issues are related to oral route rather than smoking, both in terms of product innovation and method of chewing. Most people with oral route of heavy or dependent tobacco use, may not benefit from ENDS or other strategies developed for smokers, so in addition to nicotine replacement therapies (NRTs), there is a need to innovate on other harm reduction products and technologies for oral tobacco users.

ENDS, also called electronic cigarettes, e-cigarettes, vaping devices, or vape pens, are battery-powered devices used to smoke or “vape” a flavored solution which usually contains nicotine.

There are many examples of countries which have successfully regulated reduced harm products. Many countries including UK, US and Japan among others are working towards their targets to reduce adult smoking rates by effectively complementing tobacco control measures along with allowing well-regulated, scientifically substantiated and less harmful alternatives to be available for the tens of millions of smokers who will otherwise continue to smoke for the foreseeable future. India has missed a public health opportunity with the bans on ENDS.

According to Dr Nimesh Desai, director, Institute of Human Behavior and Allied Sciences (IHBAS), psychiatrist and public health professional, “It is largely a case of socio-cultural and philosophical reasons rather than medical science. There is an urgent requirement for policy makers to become pragmatic incorporating scientific research and insights behind regulations. Over the last 20 years, there is enough data which indicates the limited success of abstinence-oriented tobacco cessation methods or NRTs with many countries struggling to build a successful cessation category. It is unfortunate, most tobacco users and adult smokers even after best treatment attempts go back to limited or previous patterns of tobacco use.”

It is also important to understand that there is no one formula which applies to all, every smoker has their biogenetics, their personality, their circumstances owing to which they cannot quit smoking. There is a need to consider different solutions for various groups and assess safer alternatives on a case-to-case basis. There is a need to provide consumers with varied and safer alternatives giving them the right to choose the best solution that works for them.

There is plenty of evidence and scientific evidence on the vast potential of the tobacco harm reduction category and how it can benefit adult smokers. There are behavioral cues that matter the most. The tobacco harm reduction benefits should be considered and complemented to support country’s tobacco control policies.

Dr Desai further explains, “Innovations need to be viewed with pragmatism and need to evolve over time. Scientific research and health benefits even in part can be seen across categories including alcohol, opioids and tobacco. In terms of public policy, Government or we tend to take extreme stand owing to political discourse, socio-cultural issues or dogmatism of medical sciences which impact laws and progressive policies.”

“The current pandemic has provided many leanings in terms of evolution of science and its impact on implementation of public health policies. Similarly, as science around tobacco harm reduction evolves, public health policies and cessation strategies need to advance keeping pace with it. As a society, we need to follow science rather than dogmatism, by investing in research and science and defining regulations which are progressive as well as benefits all stakeholders,” Dr Desai further said.


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