E-cigarettes (ECs) has changed the tide of tobacco control movement around the world. Vaporizer and other nicotine delivery device users are rapidly growing. E-cigarettes are devices with liquid cartridge container, batteries, and a heating element. The common ingredients of vapor are nicotine, propylene glycol, flavorings, and other substances. The nicotine itself, derived from tobacco plant. Some may half-agree to call it tobacco product, because the liquid may not contain nicotine. From terminology to marketing, e-cigarettes left us amidst haze of questions.

On August 9th 2017, “Panel Discussion on Potential Alternative Tobacco Product” held by Yayasan Pemerhati Kesehatan Publik (YPKP), in collaboration with LIPI and MOVI (Ministry of Vape Indonesia). First speaker, from The Indonesian Public Health Association (IAKMI), spoke about national health framework, briefed us a concept of Public Health: promotion, prevention, curative, and rehabilitation. She about conventional cigarettes, the hard-fought battle against it, and showing that vape may be the answer as an alternative product. Second speaker, from Academic Leadership Grant (ALG), a dentist, shared about her husband’s cigarette addiction, then presented scientific journals of ECs and emphasized ALG team’s visit to Global Nicotine Forum 2017 in Poland to present their paper on vape, making sure we understand it was positively welcomed in international-leveled forum. Third speaker, from MOVI, shared his story with conventional cigarette and how he switched to vaporizer.

I was running late to the event that day, I never thought that I was running late on the development of e-cigarettes issue too, am I not? I thought the discussion was an investigation of e-cigarettes viability as an option, turns out it was a pro-vaporizer’s defense.

As far as I know, prominent scientists are endorsing e-cigarettes as part of the solution from global tobacco epidemic, which they already presented at the event, but they didn’t mention The International Union Against Tuberculosis and Lung Disease stated that “The safety of electronic cigarettes (ECs) or electronic nicotine delivery systems (ENDS) has not been scientifically demonstrated.” (The Union, 2014) They also didn’t mention there are also scientists who stands with The Union, a pediatrician voiced his concerns about e-cigarettes through Review Article “E-cigarettes: vulnerability of youth” because nicotine is highly addictive and highly harmful to developing of brain and other organs. (Schraufnagel, 2015)

If we want to investigate, the very least thing we have to do is to consider both sides before we decide our stance and ask the right questions. Some confusions must be answered before we accept the pro-ECs view, for example why are we not treating nicotine patch or nicotine gum as much as vape, which serves the same purpose as vaporizer, as a viable harm-reduction device? They have the scientific evidence advantage over vape and are already accepted among health organizations. If vape is accepted as a harm-reduction device, then we too, have to agree that it must not promote normalization of smoking, it must be prescribed just like medicine: by trained health workers. If we can’t agree on that, then it must be cautiously regulated to avoid irrational use, regarding “vulnerability of youth”.

The presenters at the event knew the issue exceptionally well, except it was one-sided from the speakers’ anecdotal view of e-cigarettes, if not, vaporizer, and it was lack of opposing journals. The climate of the discussion was, in my mind frame, showing signs of reckless need of alternative tobacco product while ignoring holistic & comprehensive Public Health approach. Indonesia needs to hasten its decision on this issue while simultaneously being cautious. Until we have a firm grip on the matter, we should not embrace anything thrown into our face in order to banish the “heaven for smokers” tattoo on Indonesia’s forehead. While we are waiting, let us agree not to go through another painful process of another tattoo, “heaven for vapers”.

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