Experts urge Health Ministry to change stance on e-cigarettes

Morning MEDtalks with Dr KK Aggarwal

New Delhi,October 07, 2018

Experts urge Health Ministry to change stance on e-cigarettes : (PTI) International experts have called on the Health Ministry to change its stand on electronic cigarettes and legalise safer alternatives to tobacco products available in India.  In a recent advisory, the Health Ministry had asked the states and Union territories to ban the use of Electronic Nicotine Delivery System (ENDS).

ENDS includes e-cigarettes, heat-not-burn devices, vape, e-sheesha, e-nicotine-flavoured hookah and other devices that enable nicotine delivery.  The ministry has adopted a policy on vaping that will harm the health of millions of Indians and protect and entrench smoking, Dr Alex Wodak, former president of the International Harm Reduction Association, said.

“Countries that aim to eradicate tobacco use usually get terrible results. It’s much more effective to try and reduce the initiation and continuing use of tobacco products as well as encouraging less risky options,” Wodak said. Dr Konstantinos Farsalinos, a research fellow at the National School of Public Health, Greece, said nicotine, while addictive, is not particularly harmful.

“E-cigarettes and other vaping products eliminate combustion and provide nicotine in a much cleaner form,” he said. In 2014, Professor Farsalinos and co-author Professor Riccardo Polosa had published a systematic review of the evidence on e-cigarettes.

“We found they are much safer than cigarette smoking.  The evidence since then has convincingly confirmed this.”  Professor Farsalinos said evidence shows vape products have led millions to quit smoking for good.

“In 2016, I studied the data from the EU and found that vaping had led more than 6 million people to quit smoking and helped millions more cut back.”

Professor David Sweanor, University of Ottawa, said Canada was among the countries that initially tried to ban vaping products but recently switched to actively encouraging smokers to switch based on the science.  “We urge the Indian government to legalize and regulate safer alternatives to the tobacco products currently available in India. E-cigarettes and safer alternatives to India’s high-risk tobacco options should be appropriately regulated,” he said.

Evaluation of out-of-office BP is important for risk stratification in treated patients with normal clinic BP. A systematic review and meta-analysis examining the prognostic value of masked uncontrolled hypertension concluded that the risk of cardiovascular events and all-cause mortality is significantly higher in patients with masked uncontrolled hypertension than in those with controlled hypertension, which was independent of follow-up length and types of studied events. No difference between the prognostic information was observed with masked uncontrolled hypertension detected either by ambulatory BP monitoring (ABPM) or home BP measurement. The meta-analysis involving 30,352 patients included 6 studies using ABPM and 5 using home BP measurement. It suggests that evaluation of out-of-office BP is relevant for risk stratification in treated patients with normal clinic BP (Hypertension, October 2018).

Medical school students in MP to get handwriting classes.Two days after Allahabad High Court fined three doctors Rs. 5,000 each for bad handwriting, Indore’s MGM Medical College announced that it will coach students in handwriting skills, reports TOI. An illegible prescription can lead to confusion and patients may end up with wrong medicines. Also, illegible scrawls often turn into legal disputes in medical insurance claims.

“We are coming up with a training session for students and a seminar session for doctors to improve their writing skills. Handwriting has long been a problem for doctors and it has turned into a social stigma. We want this to end,” said Dr Bindal.

Delhi High Court has issued notice in a petition seeking closure of online pharmaciesthat are offering drugs and prescription medicines through websites. A single-judge Bench of Justice Vibhu Bakru issued notice to the Central Government, Delhi Government, Central Drug Standard Control Organization and Commissioner of Food & Drugs Administration. The Petition, filed through Advocate Amit Gupta, submits that the sale of drugs and prescription medicines online is illegal and without any mandate of law.

Sale and purchase of drugs is regulated by various legislative enactments and rules, such as the Drugs and Cosmetics Act, 1940, Drugs and Cosmetics Rules, 1945, Pharmacy Act, 1948, Pharmacy Practice Regulations, 2015, Indian Medical Act, 1956, Code of Ethics Regulations, 2002, and Drugs and Magic Remedies (Objectionable Advertisement) Act, 1954. However, “the online pharmacies are not following any of the provisions and are allowed to operate freely”, the petition states. This, the petitioner argues, is in violation of Articles 14, 19 and 21 of the Constitution of India as it results in denial of a level playing field between the online and the offline pharmacies.

Urologic surgeons at the Cleveland Clinic are the first in the country to successfully perform prostate surgery using a new generation of robotthat inserts surgical instruments through a small incision. Surgeons used the Single Port SP Robot from Intuitive Surgical to remove cancerous prostates as well as an enlarged prostate blocking the urinary system through the bladder.

• Vedic Health – A Dialogue with Ashwini Kumar Choubey https://www.youtube.com/watch?v=wdorsM5IZTQ
• TEDx Video: Doctor-patient relationship https://www.youtube.com/watch?v=i9ml1vKK2DQ

Dr KK Aggarwal
Padma Shri Awardee
President Elect CMAAO
President Heart Care Foundation of India