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E-Cigarettes: Heroes or Villains?

When racer Rally Marina set up her electronic cigarette business last year, she brought a promise of curing people from their nicotine addictions, like the one she used to have

Yuliasri Perdani (The Jakarta Post)
Jakarta
Wed, March 11, 2015

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E-Cigarettes: Heroes or Villains?

W

hen racer Rally Marina set up her electronic cigarette business last year, she brought a promise of curing people from their nicotine addictions, like the one she used to have.

'€œI was a heavy smoker. I used to smoke two packs of kretek cigarettes a day. I was finally able to completely cease my smoking habit in July last year after using e-cigarettes. I know exactly how hard it is for smokers to stop smoking. Therefore, I opened this store,'€ said Rally, a member of the Top 1 GT Radial Racing Team.

Rally and her husband were first introduced to e-cigarettes, metal tubes that heat tobacco liquids and nicotine into a vapor when sucked, by a friend during a racing event in Malaysia.

At first, Rally mixed a tube of flavoring with six milligrams of nicotine to quench her smoking cravings and later downgraded it to three milligrams. Later on, she cut out the nicotine and only smoked her favorite flavorings: butterscotch and melon mint.

'€œI stopped vaping in September,'€ she said, using the colloquial term for smoking e-cigarettes.

Unlike Rally, Brian Prakoso, a 24-year-old university student in Jakarta, uses e-cigs simply to follow the trend. Every Thursday, he gathers with his vaping club at a convenience store in Duren Tiga, South Jakarta, to smoke and share stories about their favorite flavored liquids and e-cigarettes, or e-cigs.

'€œE-cigs only reduce my tobacco cravings. I smoke cigarettes regularly and use e-cigs only when hanging out with my vaping club,'€ Brian said.  

As more people try e-cigs, whether as stop-smoking aids or for recreational use, the government has yet to set its stance on them, a smoking innovation first produced in China in 2003.

Since last year, the Health Ministry has expressed concerns over the surging trend of e-cigs, in the country and is drafting a regulation on it.  

Lela Amelia, the head of a sub-division of the Cigarette Control of the Food and Drugs Monitoring Agency (BPOM), raised concerns that e-cigs may not be effective stop-smoking aids and that instead they can be misused to consume illegal drugs.

'€œIt is predicted they can become gateway drugs, meaning that using e-cigs may prompt nicotine addiction and be used to consume other drugs, such as cocaine,'€ Lela said, quoting research published by the New England Journal of Medicine, during a recent discussion in Jakarta.

There is also a concern that e-cigs could encourage non-smokers to smoke, said Prof. Tjandra Yoga Aditama, the head of the Health Research and Development Center of the Health Ministry.

'€œWhat concerns me the most is public perception about the device. People may falsely perceive it as a harmless device, prompting non-smokers to try it,'€ he said.

Prof. Gerry Stimson, professor emeritus at Imperial College in London, believes that e-cigs have the potential to become '€œthe magic bullet'€ to stop smoking and will not serve as a getaway to nicotine addiction among non-smokers.

'€œThe survey shows that only a small percentage of e-cigarette smokers have never smoked. In the UK, it is about 1 percent of e-cigs users that have never smoked. And at the same time, as e-cigs have become popular, smoking prevalence is actually going down,'€ he suggested.

Stimson is one of 53 top scientists who have warned the WHO not to classify e-cigs as tobacco products, noting that they provide a healthier alternative to traditional cigarettes.   

Many of studies claimed to have found that the vapor of e-cigs contains no carbon monoxide, fewer cancer-causing chemicals and less nicotine residue compared to tobacco cigarettes.  

However, in August last year, the WHO recommended smokers to use already-approved nicotine addiction treatments, rather than e-cigs, because of insufficient evidence on the effectiveness of e-cigs to help users quit smoking.

Tjandra noted that the lack of independent studies on e-cigs and the rapid growth of e-cig liquids, which now has reached some 8,000 varieties, have posed a challenge for the Health Ministry to complete regulations on them.

With the absence of regulations, e-cigs are sold freely on the internet and in electronics stores, creating loopholes for underage people to buy them.

Rally, who markets her products on indovaporshop.com and over her Instagram account, says she prefers to sell e-cigs to smokers.

'€œSome of my customers are college students, who never smoked. I always suggest them to not buy e-cigs because they may lead them to smoke tobacco cigarettes,'€ says Rally, who offers e-cigs with price tags ranging from Rp 100,000 (US$8) to Rp 5 million apiece.

As for e-cigs users, they are left to set their own safety standards.

Rally'€™s husband, Fitra Eri, says he only picks flavored liquids that have been approved by the US Food and Drug Administration (FDA). Meanwhile, for Brian, the most important thing is to choose e-cigs and liquids that can produce the thickest white plumes.   

'€œI am aware that there are still pros and cons for smoking e-cigs, but personally I never felt any side effects of vaping. Most vaping enthusiasts focus on producing dense vapors or seeking the best flavors. For me, it is all about the vapors,'€ he says.

As one of the countries with the highest prevalence of smoking in the world, Indonesia needs to carefully regulate the use of e-cigs.

'€œIf the regulation is too tough on e-cigs, you can actually favor regular cigarettes,'€ Stimson suggested.

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