June 3, 2018 Rendez-vous #11
with Samrat Chowdhery
Samrat is one of the co-founders and directors of Association of Vapers India (AVI). You can also visit them on Facebook and Twitter.
Thank you Samrat for accepting this rendez-vous.
Q1. I just read the opinion you published on January 5 2018 about the prohibition threats against vaping in India, as well as the interview about AVI you had on December 20, 2017 for ecigclick. A few months later, how do you assess the situation: could a prohibition be enacted at the national level in India? Are other states (beyond the 5 that have done so) considering prohibition? Are other regulatory options considered?
Samrat Chowdhery: The situation, unfortunately, has become worse since. A large state, Bihar, has also taken the extreme step of banning vaping. This ban is ghastlier than others because along with sale, it prohibits the use of electronic cigarettes, effectively criminalising vaping. Putting people in jail for trying to save their lives has to be the lowest low in public administration. A few more large states with millions of smokers – Maharashtra, Delhi and Rajasthan – are also considering bans.
The central government, too, has stated in a court filing that it is considering banning vaping over debunked claims like gateway effect and the usual gripe of nicotine is harmful, while leaving out any explanation of why cigarettes and NRTs are not banned too.
Q2. AVI has filed lawsuits against the prohibition laws. Can you give us some details and tell us what are the consequences of such bans on vapers? How effective are they? Are vapers aware of this threat?
Samrat Chowdhery: The legal process is expensive and time-consuming, more so in India which has huge pendency of cases. Hence, it is always the last option. We tried various means to reach out to lawmakers to present our view and help them see vaping as a tool against tobacco use, but with no results. We sensed a strong WHO influence, lack of awareness, and plain refusal to consider tobacco alternatives even in the face of credible evidence. On the other hand, the number of bans kept increasing at an alarming pace, which left us little choice but to approach the courts to protect the right of people to lead healthier lives.
Fortunately, we have found support in the legal community, many lawyers are vapers themselves and understand the importance of our cause. This has helped bring down costs as some cases are being fought pro bono.
At present, AVI is fighting three cases – two Public Intererest Litigation (PIL) challenging vape bans have been filed in Karnataka and Jammu & Kashmir, while in a PIL filed in Delhi in which the central government is a respondent, we have intervened to ensure our perspective and concerns are heard before a decision is made. We expect this case to go to the Supreme Court. You can learn more about the progress in these cases, and the arguments on both sides by visiting here
On how effective these bans are, I would like to say two things. The first point is taking from what happened in Karnataka where vaping was suddenly banned in mid-2015. Until then Bangalore, an international tech hub, had a large number of vapers some of whom would vape in the smoking rooms of their offices during breaks. After the ban, however, they started being looked upon with suspicion and derision, forcing them to go back to smoking. The social pressure a ban builds will slow down adoption and the negative image will take years to correct even after the ban is lifted. We have seen this happening in some countries too that have tried to demonise vaping.
Apart from the perception issue however, there is little that can stop the adoption of vaping and certainly not a ban. India is quite porous when it comes to implementation of prohibition. With people having access to independent information online, it is safe to say an increasing number of smokers will shift to vaping in the coming years irrespective of what the government decides. At best, with a ban it may be able to stunt the rate of adoption of vaping and create some confusion in the minds of people about its relative safety.
Q3. In Canada, one of the most convincing and vocal advocate in favor of vaping is a cardiac surgeon of Indian origin, Gopal Bhatnagar. In Québec, three physicians pleaded for e-cigs during Parliament hearings in 2015, in France 100 physicians signed in 2013 an appeal in support of e-cigs; are there physicians in India willing to do so? Are there 'celebrity' vapers who could act as public champions and help out? Any vapers in Bollywood?
Samrat Chowdhery: I am very appreciative of Mr Bhatnagar’s efforts and how well the situation has turned out in Canada due to their collective work. It is very important that medical professionals see the benefit of switching smokers to less harmful alternatives. In India we don’t have this large momentum yet as there is little awareness about tobacco harm reduction as a concept, and also because of resistance from the Indian Medical Association, which unlike medical bodies elsewhere is not really independent and toes the government line. We saw this subservience first-hand when the Indian Dental Association intervened in the PIL filed by us in Karnataka, but never actually submitted its objections, in a clear attempt to delay the case and demotivate us. The intervention was later removed by the court and the case is back on track.
A clutch of Right to Information appeals filed by us also show that the country’s premier tobacco and cancer institutes have not even bothered to look at the science behind vaping or measured its relative impact versus smoking. This clearly indicates there is no willingness to study the issue despite vaping currently being the most popular means to quit smoking worldwide. You can remark at the absurdity of some of the RTI responses here.
There are, however, doctors who are privately recommending vaping to heavy smokers, but are reluctant to back vaping in public for the fear of offending IMA and other bodies. There are some who are beginning to come forward and their contribution will be crucial.
We know of a number of celebrities who vape but appeals to champion it as a safer alternative have not worked so far. India and most Asian countries are far from even considering the pleasure principle and anything related to tobacco is taboo.
There is growing awareness among vapers of the impact of a ban, but many feel reasonably sure they will get by, given how difficult it is to impose bans in the country. Vapers in states where prohibition has been imposed have found a way.
Q4. You recently attended in Tokyo a meeting of vaping advocates from Asian countries. Can you tell us about it?
Samrat Chowdhery: It was a fruitful meeting. The countries of Asia and more broadly Asia Pacific have a lot in common. The most important is that the population of smokers in the region is high, even growing in some parts, and is projected to stay this way for some time. The countries have similar socio-economic conditions and tradition-bound mindsets, which as I said has no room yet for the pleasure principle or the acceptance that nicotine without the harmful delivery through combustion can be legitimately pursued. Despite the acute need for harm reduction, this also where WHO wields the most control, and with the help of kow-towing governments is pushing for banning safer alternatives.
It is therefore key that a collective effort be made to push back. This is not to suggest the region decouples from harm reduction efforts being made worldwide, a global effort like INNCO is much-needed, but a sharpening of focus is required if Asia is to be saved from the destruction of the tobacco epidemic. A coalition is being worked out between the advocacy groups of the region, which includes bringing advocates from more countries into the fold and supporting each other through sharing of information and resources. We hope to see results from this in the near future.
Q5. How best could/can the international community help your efforts?
Samrat Chowdhery: There is a feeling among advocates here that despite having so many smokers (120 million) and despite there being urgent need for harm reduction, the country has been largely ignored in global efforts to mitigate tobacco harm. It is perhaps because of the fallacy that many smokers in India won’t be able to afford these devices, or it could be because of the sheer number of tobacco variants in use here, which can appear daunting to address for anyone considering alternative methodologies.
But both these concerns are shallow. Vaping technology can be made available to beedi smokers, the lowest in the rung, at price points they can afford. This infact is the subject of a study I am conducting under a grant from GFN, which looks at the affordability and effectiveness of vaping for beedi smokers. A preliminary analysis finds that low-end vaping kits (CE5 pens) are within range, and Indian eliquid manufacturers can produce at affordable rates. What we need to look at in detail are the nuances of shifting users from beedi to vaping, for which some manufacturers have been roped in to incorporate feedback from the test users.
The wide range of tobacco products are a challenge, since each will require a tailored intervention, from finding suitable alternatives to perception change depending on the social and economic backgrounds of the users. But it is a challenge we have to take on, and there is already is a remedy available in the form of snus. Whether it can also work for those who consume tobacco with areca nut (gutka) remains to be tested.
I believe the international community can and should play a significant role in helping shape the India tobacco harm reduction story. What happens in a large, democratic nation like India has a bearing on the entire region and for other developing nations where vaping is facing similar resistance.
Through an international push, the government needs to be made aware of the science and the evidence, and how vaping has benefited public health in other nations. Seminars held here at which well-known and respected international advocates speak to the media and the people, and a representation or communique by pro-vaping governments, researchers and advocates to the Indian government will also go a long way in dispelling its reservations.
Medical professionals can play a critical role by speaking to their counterparts here to make them aware of the science and the benefits, transfer scientific knowhow and guide them on how to prescribe vaping to their patients.
We have to keep in mind that among the considerations of the government in banning vaping is its potential impact on the large number of tobacco farmers and the loss of tobacco tax revenue. Both are legitimate concerns in an agrarian and developing country, and ones which can only be addressed by providing the government with viable alternatives and instances of how other nations have dealt with these issues. Funding research and finding solutions that work in India are also required, for which the Foundation of Smoke-Free World has taken some concrete and welcome steps.
Q6. Is there anything else you would like to add?
Samrat Chowdhery: The coming few months are crucial. The central government is likely to announce a policy on ENDS as the court hearing date of August 21 approaches. COP8 in October will also be on its mind. If, however, there is no decision by then, I believe we will have some breathing room since national elections are due next year and no major decisions will be made in the run-up to it.
Our efforts in this time will be centered around meeting government officials to sensitise them, pushing forward with the cases and creating awareness among people about tobacco harm reduction and safer alternatives.
Thank you Samrat for having taken the time to participate in this rendez-vous.
I do support AVI and urge to the vapers and smokers of India to come together and do whatever they can to reduce harm of combustible tobacco and promote vaping which is much healthier alternative.
Posted by: Bhupinder Singh | 06/04/2018 at 06:38 AM