Nineteen-year-old Amit, who’s currently in his gap year, started vaping two years ago. He says he isn’t addicted to it—he barely experienced any withdrawal syndrome when he quit it last year, before picking it up again. Amit, who the Post is identifying with a pseudonym to protect his privacy, says he vapes just because he wants to.

Unlike Amit, Rita (name changed), who is 21, switched to vaping after smoking tobacco for a while. Rita says that since she hopes to quit smoking altogether, she doesn’t mind the Nepal government’s intention to put a blanket ban on e-cigarettes.

But doctors say a ban may lead those who smoke vape to switch to smoking tobacco again.

As debates continue around the world about the pros and cons of vaping compared to smoking tobacco, the Nepal government earlier this month announced that it was banning e-cigarettes.

The National Health Education, Information, and Communication Center (NHEICC), under the Department of Health Services, says it is seeking help from other ministries to enforce the ban. While some vape users the Post talked to said that the ban would help them quit smoking altogether, there are other aspects of the ban that need a more careful consideration for youths’ health, experts say.

Meanwhile, some other users said banning vapes makes little sense as tobacco cigarettes are still freely available in the market for people of all age groups. If the government is so concerned about youths’ health, they question, shouldn’t stricter measures be taken to ensure that minors, for instance, don’t purchase cigarettes?

Nepal is not the only country to ban e-cigarettes of late. Most recently, the British prime minister announced a ban on all disposable cigarettes, citing risks to youth health following a significant rise in vaping.

There are 33 countries that have altogether banned the sale of Electronic Nicotine Delivery Systems (ENDS), while according to a WHO report published in early 2024, around 74 countries have no regulations on the sale of e-cigarettes.

Most countries in the world have a legal age to purchase traditional cigarettes, according to the WHO, while 88 countries have no minimum age limit to buy e-cigarettes.

Moreover, the WHO has repeatedly urged countries around the globe to reduce the spread of e-cigarettes. A call to action was published in December last year, urging governments to strengthen regulations on e-cigarettes.

Nepal, meanwhile, has no regulations on e-cigarettes.

While they haven’t banned e-cigarettes outright, countries like China have imposed a number of regulations, including licensing to sell the products publicly, ban on flavoured products, and imposition of taxes.

In a study on the prevalence of e-cigarette usage among undergraduate students in Kathmandu, 21.2 percent respondents said they never used e-cigarettes, while five percent said they currently used cigarettes. An estimation of global e-cigarette use put the number of its users at 82 million worldwide, 14.2 million of them in South Asia.

Most countries cite e-cigarettes as a contributor to youth smoking.

Nepalis do not need to produce an ID to purchase either tobacco cigarettes or e-cigarettes. Amit, for instance, was still a minor when he started vaping. That these harmful products are freely available to people of all age groups goes against the Tobacco Products (Control and Regulatory) Act, 2068 (2011), which says that it is illegal to sell tobacco products to those below the age of 18.

“A stricter control on the sale of tobacco products is essential to curb smoking among youths,” says Dr Bhakta Bahadur KC, chief of Health Promotion and Tobacco Control at NHEICC.

KC adds that to prevent minors and pregnant women, who are more vulnerable to the risks of smoking, from purchasing cigarettes, local governments should introduce provisions on licensing. “This is one way to control smoking in vulnerable groups,” says KC.

Moreover, banning e-cigarettes fully may not be possible as they are widely sold through social media and smuggled products might still be available for purchase online.

The NHEICC is currently calling on other ministries, including the Ministry of Information and Technology, and the Ministry of Industry, Commerce and Supplies, to help it ban e-cigarettes as they are imported from foreign markets.

“Right now, the NHEICC is focused on banning e-cigarettes as a whole due to its adverse effects on the health of young adults, and its role as a gateway to tobacco smoking,” KC says.

But Dr Augraj Uprety, Doctor of Medicine at the BPKIHS Department of Pulmonary Critical Care and Sleep Medicine in Dharan, provides a different perspective.

With the ban on vapes, youths may find themselves attracted to tobacco smoking, as a significant number of vape users, like Rita, turn to e-cigarettes, supposedly to protect themselves from the harmful impacts of tobacco cigarettes.

“Banning e-cigarette is not a cure-all,” Uprety says. “It is also vital to focus on handling the nicotine-dependence syndrome which both tobacco and e-cigarette users experience.”

Both tobacco cigarettes and e-cigarettes contain nicotine, a highly addictive chemical, but tobacco cigarettes contain higher amounts of toxic chemicals than e-cigarettes. But studies show that e-cigarettes are especially harmful for youths as they affect adolescent brain development due to exposure to nicotine, and the aerosol in e-cigarettes has known effects on lungs.

Further, there is little knowledge about the long-term impacts of e-cigarettes as it’s a relatively new technology.

“I will never say banning e-cigarettes is a bad thing. It is an important move,” Uprety says. “But we also need to conduct a pilot study to figure out the repercussions of a potential ban.”