Electronic nicotine delivery system: a narrative review on growing threat to tobacco control and health of the young Indian population.

The electronic cigarette (EC) was developed as an alternative to cigarette smoking. In less than a decade, the prevalence of past-month EC usage increased from 1.5 to 27.5 % among US high-school students. In the coming years, Asia-Pacific countries will have the highest sales of electronic nicotine/non-nicotine delivery systems (ENDS/ENNDS) after Western Europe. Based on the World Health Organization and Indian Council of Medical Research recommendations, India approved a complete ban on EC in 2019. Even though it has been three years since the ban, EC is still being sold in India's grey markets, where marketing is not regulated. In this narrative review, we discuss that vaping is not just a harm reduction strategy for tobacco smoking cessation but poses a serious threat to India's existing tobacco control efforts as well as the health of the country's young people.