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Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: repeat national cross sectional surveys

BMJ 2019; 365 doi: (Published 20 June 2019) Cite this as: BMJ 2019;365:l2219

Linked Editorial

Tobacco control: new resources, existing treaties, and emerging challenges

Rapid Response:

Re: Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: repeat national cross sectional surveys

The research paper indicates the increased prevalence of vaping among adolescents in Canada and the USA. The study also supports the belief that younger people are more attracted towards this new trend of Vaping. The rules of marketing of vaping products in different countries attribute distinct prevalence patterns in different countries. There is a need to focus and pursue more research on vaping behaviour, including specific products and more frequent use among the population.

Though there is a lack of substantial research to estimate the accurate prevalence vaping in India (1), healthcare professionals, school principals, and policy makers have regularly expressed their concern on the increased use of e cigarettes in India.

A news article reported (2) serious concerns expressed by school principals in New Delhi regarding the increasing trend of vaping in young students. The report also quotes a seller reporting that sale of these devices has increased since they were introduced in 2007 and the schools are surrounded by the shops selling these devices. The market of e-cigarettes is expanding in India, and it is evident from the fact that Market Research projects the compound annual growth of Indian E- cigarettes industry as 63.38% for the period 2013- 2018. (3)

The Indian government is not taking things lightly. The Ministry Of Health And Family Welfare has issued an advisory (4) on August 28, 2018 in which it is said that the ENDS products (including E-Cigarettes, Vape, E-shisha, nicotine flavoured hookah) should not be sold, manufactured, distributed, traded, imported and advertised in the jurisdiction. Twelve states (Punjab, Maharashtra, Karnataka, Kerala, Bihar, Uttar Pradesh, Jammu and Kashmir, Himachal Pradesh, Tamil Nadu, Jharkhand) in India have already banned vaping in their jurisdiction. The Ministry of Electronics and Information Technology (MEITY) has also proposed an amendment to the Information Technology (Intermediary Guidelines) Rules 2018 to ban the advertisement of e-cigarettes. Meanwhile, the Central Board of Indirect Taxes and Customs has issued a circular – referring to an advisory from the Union health ministry – that all import consignments of e-cigarettes must be cleared by the drug controller first. (5)

The Indian Council of Medical Research in its white paper on ENDS recommends complete prohibition on ENDS products or E-Cigarettes in India in the greater interest of protecting public health (6). As reported by India News on January 21, 2016, the Indian Medical Association discourages the use of e-cigarettes for quitting smoking as it causes severe health risks in disguise (7); studies have reported vaping as a way for quitting smoking but health risks are also attached to it. (8)

1. Thampi V, Nair R, Rawat R, Mikhail A, Dey S. A review study on Vaping in India. J Cancer Clinical Trials. 2018;3:147
2. Chhetri S. Vaping new headache for Delhi schools as fad catches on, Times of India. Published on May 26, 2019. [Last accessed on July 1, 2019 ]
3. Roopa SR, Augustine D, Nambiar S, Vanisher CH, Sowmya SV. E-cigarettes in India - An invite to oral cancer. Journal of Advanced Clinical & Research Insights. 2017; 4:136–138
4. Ministry of Health and Family Welfare, Government of India. Advisory on electronic nicotine delivery system (ENDS) including e-cigarettes, Heat not Burn devices, Vape, E-sheesha, e-nicotine flavoured hookah, and the like products. Published on August 28th, 2019. [Last accessed on July 1, 2019 ]
5. Bhuya A. Three ministries advance regulations to control E- cigarettes. The Wire. Published on January 8, 2019. [Last accessed on July1, 2019]
6. Chakma JK, Dhaliwal RS, Mehrotra R. Indian Council of Medical Research. White paper on Electronic Nicotine Delivery System. Indian Journal of Medical Research. May 2019
7. PTI, India Today, IMA disapproves use of e-cigarettes as a way to quit smoking. Published on January 21, 2016. [Last accessed on July 1, 2019 ]
8. Ghosh S. Drummond MB. Electronic Cigarettes as smoking cessation Tool: Are we there?. Curr. Opin. Pulm. Med. 2017;23:111-116

Competing interests: No competing interests

04 July 2019
Smita Asthana
Scientist E
Saba Abidi, Satyanarayana Labani
Indian Council of Medical Research- National Institute of Cancer Prevention and Research