New Delhi: E-cigarettes are easily available at tobacco shops and sold to anyone without any age verification, the findings of a joint survey have revealed. The findings have been shared with the Union health ministry.


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The survey conducted across six states -- Assam, Goa, Haryana, Uttar Pradesh, Karnataka, and Telangana -- and Delhi also found that e-cigarettes get delivered within a couple of days when ordered online (through e-commerce websites, exclusive vape websites, WhatsApp, Instagram, Facebook and other social media sites) and are sold without any age verification.


Also, most of the vendors are not aware that e-cigarettes have been banned by law and are openly selling those, and the e-cigarettes that are being sold are mostly manufactured in China, the survey conducted by five organizations -- Voluntary Health Association of India, VOICE, Nadda India, National Law School University India, Bangalore and Karnataka NO for Tobacco -- said.


Despite the ban clamped by the government in 2019, e-cigarettes are easily available at tobacco shops and sold to children below 18 years of age, it added. Shops and vendors were randomly selected for the survey. A total of 100 points of sale were surveyed across the six states and Delhi. The survey was conducted both online and offline.


The field investigators checked on the availability of e-cigarettes, age verification, awareness on the ban and subsequent penalties in case of being found guilty among the vendors.


The survey also found out that e-cigarettes are available among the tobacco vendors operating near educational institutions. Some tobacco vendors do not sell such products but assure a doorstep delivery in accordance with demand.


While ordering online, a few websites ask for age verification, which merely requires ticking a checkbox asking whether the customer is aged 18 years or above, the survey said while pointing out that most of the e-cigarettes that are being sold are manufactured in China.


The key findings of the survey were presented at the National Consultation on the Enforcement of Prohibition of Electronic-Cigarettes Act 2019 -- Challenges and Way Forward, which was held here on February 23.


E-cigarettes were banned to protect youngsters from a new form of toxic addiction. However, its enforcement has been weak, resulting in the market being flooded with cheap and unbranded China-made e-cigarettes. Thus, a coordinated effort at the central and state levels is urgently needed to ensure that the ban is effective, said Bhavna Mukopadhyay, chief executive, the Voluntary Health Association of India.


Considering the harmful effects and the alarming rise in its prevalence among youngsters, the government prohibited the production, manufacture, import, export, transport, sale, distribution, storage and advertisement of e-cigarettes, including all forms of electronic nicotine delivery systems, heat-not-burn products, e-hookahs and such other devices, called by whichever name and irrespective of their shape, size or form, vide the Prohibition of Electronic Cigarettes (Production, Manufacture, Import, Export, Transport, Sale, Distribution, Storage and Advertisement) Act, 2019, which was introduced as an ordinance and subsequently formalised into an Act in 2019.


"E-cigarettes were banned in India due to the health risks they pose and to ensure that they do not become an epidemic among children and young adults. The government must ensure the effective compliance and enforcement of the ban," Dr Harit Chaturvedi, chairman, Max Institute of Cancer Care, said.


Despite heavy penalties and even imprisonment, e-cigarettes are reported to be widely available across a range of sources, including tobacco vendors, general stores and online providers, Chaturvedi said, adding that a rampant use of such products has been observed among youngsters, including school children. It thus appears that e-cigarette marketers have illicitly managed to achieve a foothold in the market that has not been completely redressed by the ban, he said.


"The prevalence of vape products, especially among teens, is a global epidemic. The government's role has been remarkable in nipping the vape menace in its bud through the enactment of the PECA. However, there is no follow-up at the ground level on enforcement. There have been very few instances of compliance, such as where the customs department has seized e-cigarettes coming in the form of toys or some other material," said Ranjit Singh, a Supreme Court lawyer.


Recently, the Ministry of Health and Family Welfare (MoHFW), in its directions to the states and Union territories, highlighted the weak implementation of the Prohibition of Electronic Cigarettes Act (PECA), 2019, leading to an easy availability of e-cigarettes online, at retail or convenient stores, stationery shops and near educational institutions.


The states were directed to review the compliance with the PECA and issue necessary instructions for an effective implementation of the provisions of the Act through special drives and random checking at schools and colleges.


As a follow-up to the MoHFW directions, the states have taken an initiative to enforce the PECA. The chairman of the Child Protection and Rights Commission of Uttar Pradesh has issued directives to all districts for a strict enforcement of the PECA. The additional director general of police, crime of Bengaluru city (Karnataka) has asked the joint commissioner, crime for a strict enforcement of the PECA and provided a list of shops where e-cigarettes are suspected of being sold.


While the Delhi Police has issued a public notice on the harmful side of e-cigarettes as well as on compliance with the PECA, there have also been reported seizures of China-made e-cigarettes from Noida and Mumbai.


E-cigarettes and such devices are battery-operated systems that heat up a substance (in liquid or solid state), which constitutes of nicotine and often flavours, to create an aerosol for inhalation. Nicotine is very addictive and creates dependence.


These act as gateway products. E-cigarettes are very attractive by way of design, come in alluring flavours (chocolate, hazelnut, peppermint, gummy bears, cr?me brulee, mango, cranberry etc.) and their use does not leave a trace of bad smell associated with conventional smoking.


Therefore, the young population, adolescents and children are particularly vulnerable to get initiated to nicotine addiction through the use of e-cigarettes. This is evident from reports from several schools in India where teachers found e-cigarettes in students' bags. Teen e-cigarette use has become an "epidemic" globally.