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On Thursday 12 December, the Bangladesh government announced a ban on e-cigarette imports, ostensibly believing this move would curb e-cigarette usage and improve public health. However, history—and compelling evidence—suggests otherwise. Far from reducing access, such bans have consistently fueled thriving black markets, transforming a public health initiative into an enforcement nightmare. By replicating India’s misstep with a similar prohibition, Bangladesh risks aggravating the very challenges it seeks to address.
When India banned e-cigarettes in 2019 under the Prohibition of Electronic Cigarettes Act (PECA), policymakers touted the move as decisive action against a looming health crisis. Yet, the reality has been starkly different. Reports highlight a thriving black market, with e-cigarettes readily available to youth and adults alike. These illicit channels offer unregulated products, heightening health risks while depriving the government of significant tax revenues.
Despite the ban, e-cigarettes are widely available in India, as evidenced by a 2023 joint survey across seven regions, including Delhi and Karnataka. The survey revealed that e-cigarettes are openly sold in tobacco shops with vendors often unaware of the law or its penalties. Social media has also emerged as a prominent platform for illicit sales, further complicating enforcement efforts. Many of these products are manufactured in China, raising additional concerns about safety and quality control.
Moreover, a study published in Preventive Medicine Reports in 2023 found that despite comprehensive bans, e-cigarettes remain easily accessible to young people in India. This underscores the ban's failure to curb access entirely, suggesting that illicit trade has taken root. Without regulatory oversight, users face heightened risks from counterfeit or unsafe vaping products, undermining the public health goals the ban sought to achieve. With the proliferation of black market and the government's inability to exert any meaningful control, the policy to not regulate by ban is increasingly looking like a mistake.
Bangladesh now stands poised to repeat this same mistake. Prohibiting imports will not erase demand. Like in India, demand for e-cigarettes in Bangladesh is unlikely to vanish overnight. Instead, the ban will almost certainly drive the trade underground, making enforcement increasingly challenging and amplifying health risks associated with unregulated products. As seen with India's black market explosion, bans do not eliminate demand—they only redirect it to illegal and often unsafe channels, undermining public health objectives.
The policy’s drawback becomes even clearer when viewed against the mounting evidence supporting e-cigarettes as an effective tool for smoking cessation. A University College London study published estimated that 50,000 to 70,000 smokers in England quit smoking every year by switching to vaping. A 2022 review by the prestigious Cochrane Library found “high certainty evidence” that e-cigarettes or vapes outperform traditional nicotine replacement therapies, such as patches and gums, in helping people quit smoking. Together, these findings add to the growing body of evidence supporting the efficacy of e-cigarettes.
E-cigarettes are not just an effective tool for smoking cessation—they represent a paradigm shift in harm reduction. These devices are significantly less harmful than combustible cigarettes. Public Health England (now part of the UK Health Security Agency and the Office for Health Improvement and Disparities), the nation’s leading public health authority, concluded in what it described as a “landmark review” that e-cigarettes are 95% less harmful than traditional cigarettes and have been instrumental in reducing smoking rates. By banning these devices outright, Bangladesh risks sidelining a proven harm-reduction strategy while driving them into an unregulated black market, where quality control and access oversight are impossible.
But e-cigarettes aren’t just a highly effective quitting tool. It presents a remarkable paradigm shift in smoking cessation because it is meaningfully less harmful than the combustible cigarettes. Public Health England (later renamed UK Health Security Agency and Office for Health Improvement and Disparities), which is England’s most authoritative public health body, has recognized e-cigarettes as 95% less harmful than combustible cigarettes and instrumental in reducing smoking prevalence in what the organization itself described as a “landmark review”. By banning these devices outright, Bangladesh is not only ignoring proven harm-reduction tools but also driving them underground, where quality control and access regulation are impossible.
There is no plausible reason for policymakers to ignore these facts. Research specific to Bangladesh underscores the transformative potential of tobacco harm reduction (THR) strategies. A 2023 study conducted by a consortium of global and regional THR specialists estimated that adopting such policies could save over 900,000 lives in Bangladesh over the next four decades. This evidence highlights the critical role THR can play in reshaping public health—an impact already demonstrated in countries that have embraced harm-reduction strategies. However, instead of seizing this opportunity to replicate these successes and significantly improve its public health outcomes, Bangladesh has chosen to ban e-cigarettes, effectively sidelining a proven harm-reduction tool.
The parallels between Bangladesh's ban and India’s experience are stark and instructive. When India enacted its e-cigarette prohibition, the intention was to curb usage and protect public health. Instead, the policy backfired, driving the trade underground and creating a lucrative black market rife with unregulated, potentially hazardous products. This outcome offers a cautionary tale for Bangladesh: bans do not eliminate demand—they merely shift it to uncontrolled channels. Without regulatory oversight, these markets not only endanger consumers but also undermine public health efforts. By ignoring this precedent, Bangladesh risks replicating India’s failures rather than learning from them.
This is not just short-sighted—it is counterproductive. Black markets thrive on prohibition, leaving consumers and the state to bear the brunt of poorly enforced policies. Illicit trade will fill the gap, enriching unscrupulous actors while undermining public health goals. Policymakers are walking into this pitfall knowingly, or worse, recklessly disregarding the evidence.
The government should instead consider a regulated framework for e-cigarettes, balancing access for adult smokers seeking alternatives with strict measures to prevent youth usage. Policymakers should consider adopting Tobacco Harm Reduction strategies used by developed countries like the United Kingdom, Sweden, Australia, and Canada. Tax revenues from a regulated market could also be reinvested in smoking cessation programs and public health initiatives, creating a win-win scenario for both smokers and society.
Bangladesh must recognize that bans, without viable alternatives, is not going to support its public health agenda. This policy risks compounding the tobacco crisis, not alleviating it. Rather strict regulations is required to slowly but surely attain the public health goals. Therefore it is urgently needed to rethink the ban approach before the damage becomes irreversible.
Dr. Altamash Mahmood, Asst. Professor and Head Department of Dentistry International Institute of Health Science & Adjunct Faculty, MPH Program Bangladesh Open University.
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