Tobacco use, particularly smoking, exacts a heavy toll in India every week but the government move to ban e-cigarettes while allowing sale of normal cigarettes does not seem justified, cancer experts said.

Addressing a press meet organised by bcbpf-The Cancer Foundation, Riccardo Polosa of the Department of Clinical and Experimental Medicine at Italy's University of Catania, Ron Borland, Professor of Psychology at the University of Melbourne, and Sameer Kaul, Senior Consultant, Surgical Oncology & Robotics at the Apollo Cancer Institute here, questioned the ban on electronic nicotine delivery systems (ENDS) in the country. 

Claiming that the Indian Council of Medical Research white paper shows "a high probability of bias", they asked why it recommended a complete ban on e-cigarettes for the "greater interest of protecting public health" but not on traditional cigarettes.

Policy-making should be based on scientifically sound evidence and where such evidence is in nascent stages, efforts must be focused on speeding up or encouraging research, they said. Kaul announced a nation-wide, cross sectional, randomized study on Indian subjects, led by bcbpf-The Cancer Foundation, of which he is the founder President.

Saying it was important to "document the well-known damaging effects of smoking against the risks and harm reduction potential of e-cigarettes", he said that the ban of e-cigarettes that have "proven social, economic and health benefits over combustible cigarettes, is not justified". 

"ENDS present an excellent opportunity for India to accelerate a decline in smoking rates and adult smokers who want to quit but may be unable to, have the right to be able to access harm reduction alternatives such as ENDS," he added.

The three experts recently co-authored and published a scientific evidence based critical appraisal of the ICMR white paper, in the Indian Journal of Clinical Practice. 

Polosa said that the ICMR paper "presented an uncritical evaluation of evidence gathered from poor quality studies", and they sought to make "a detailed, critical appraisal of all existing evidence on ENDS" in a bid to "convince ICMR to reconsider their recommendation for a complete prohibition of the category".

He said many reputed scientific institutes now acknowledge that ENDS pose significantly less health risk compared to traditional cigarettes or bidis. As many as 69 countries, like the UK and Canada, have regulated ENDS while the UAE has reversed its ban. 

Borland said that e-cigarettes are an "important tool" for smokers to reduce their risk and this opportunity to improve public health will be lost if India continues to bans e-cigarettes.