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First-Ever India-Based ENDS Study Says E-Cigs 'Less Health Risk' Than Cigarettes

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Published in the Indian Journal of Clinical Practice, a new study coming out of India is the first of its kind — and it’s a great one for vaping advocates.

“Systematic review of 200 published scientific literatures,” was conducted by Professor R.N. Sharan from North-Eastern Hill University in Shillong, India; Dr. Sambuddha Das; and Dr. Yashmin Choudhury from Assam University; and Dr. S. Thangminlal Vaiphei from Central University of Rajasthan. The researchers found that electronic nicotine delivery systems (ENDS), otherwise known as e-cigarettes, “pose much less a health risk than combustible cigarettes.” Additionally, the researchers say that e-cigarettes, “could be an ideal tool to reduce or give up smoking,” according to Outlook India.

The study’s findings came after a comparison of nicotine, various other chemicals and metal ions produced both during smoking and vaping. Findings of the study include:

  • newer generation ENDS was an efficient means of meeting the nicotine demand and could help the cigarette smoking population quit the addiction and prevent tobacco harm reduction
  • toxic chemicals such as carcinogens and other toxicants were found in significantly higher quantities in conventional cigarette smoke as compared to the vapor from an e-cigarette
  • metal ion Cadmium, which is a Class 1 carcinogen, a respiratory, reproductive and developmental toxicant, was found to be over 1,369 times higher in cigarette smoke than ENDS vapor
  • Lead and Chromium, which are Class 2a probable carcinogens, were over 12 and 13 times, more respectively in cigarette smoke
  • Cigarette smoke was also found to have "significantly higher levels of Class 1 carcinogens such as formaldehyde (over 8 fold), benzene (22 fold) and NNK (over 92 fold), and Class 2a probable carcinogens, including acetaldehyde (over 91 fold), Propanediol (over 53 fold) and Isoprene (over 17 fold), among others, in comparison to vapor of e-cigarettes
  • risk of acute toxicity from direct ingestion of nicotine was highly unlikely to arise due to e-cigarette use, as ENDS delivered about 1mg of nicotine in blood (equivalent or lower to a cigarette), whereas its known toxic level was in the range of 30-60 mg
  • ENDS usage was higher among former smokers than non-smokers by nearly 4.13 fold, signifying that they could potentially become a useful aid in smoking cessation
  • Use of ENDS was found to be 7.53 times higher in smokers than in non-smokers, which indicates that, contrary to perception, e-cigarettes are less likely to be a gateway to nicotine use but are more likely used by smokers to reduce tobacco harm or quit smoking

The team told Outlook India that even though there is increasing awareness and regulatory measures to discourage cigarette smoking, there is still a tobacco burden not on the decline. Therefore, “alternatives for tobacco harm reduction like ENDS or e-cigarettes, need to be evaluated.”

Sharan, former president of the Indian Society for Radiation Biology, said, “This up-to-date systematic review and meta-analysis is the first attempt by experts in India to audit the health and safety aspects of conventional cigarette smoking and ENDS in order to objectively evaluate the suitability of ENDS as a less harmful alternative to conventional smoking. Through this study, we have called for rational policy making with the objective of maximizing benefits and minimizing potential risks by extending the benefits of ENDS to smokers who choose to use them as smoking cessation tools, while preventing the misuse of ENDS by never smokers, adolescents and children.”