Tobacco use remains one of the leading global disease risk factors because every year more than 8 million people die from tobacco use according to the World Health Organisation. Whereas risks associated with cigarette smoking are evident such as its potential to worsen or prolong the symptoms of respiratory conditions such as asthma or even damaging the heart and blood circulation, people still smoke. The 2014/15 Rwanda Demographic Survey showed that prevalence of tobacco use among Rwandans was: 10% in men aged 15-59 (who smoke cigarettes and other tobacco products) and 2 percent of tobacco use in women aged 15-49 (who smoke cigarettes, pipes and other tobacco products). In a bid for the tobacco industry to avail a ‘safer’ product, they invented electronic cigarettes (also known as smokeless cigarettes or e-cigarettes) and it’s promoting it as a safer and healthier alternative to regular cigarettes. An electronic cigarette is basically a battery-operated device that emits doses of vaporised nicotine or non-nicotine solutions, for the user to inhale. It aims at providing a similar sensation to inhaling tobacco smoke but without the smoke-this process is called vaping. Tobacco manufacturers claim that e-cigarettes sidestep many of the health risks of tobacco smoking for they do not contain the harmful chemicals such as tar and carbon monoxide that are found in tobacco cigarettes. Robert Mihigo, a smoker says e-cigarettes are less harmful but more addictive. He believes traditional cigarettes carry more health risks because of the presence of toxins and carcinogens in tobacco smoke. “Normal cigarettes are more harmful yet addictive as e-cigarettes. So I would rather use e-cigarettes to eliminate the health complications associated with smoking ordinary cigarettes,” he says. Dr Moira Gilchrist, vice president strategic and scientific communication at Philip Morris International – a Swiss-domiciled multinational cigarette and tobacco manufacturing company, notes that a new conversation on smoking is urgently needed and that all voices must be at the table – just as is done to tackle other major global health/environmental challenges. A tobacco company like Philip Morris wants to stop selling cigarettes because it’s the right thing to do, according to her. For years, Gilchrist highlights that the industry has been asked to develop less harmful products and today, advancements in technology and science have made this a reality. “Our commitment to smoke-free alternatives is no passing whim, but the result of many years of careful deliberation, backed up by a substantial research and development program.” Based on population trends, the World Health Organization (WHO) estimates there will be more than 1 billion smokers by 2025, about the same number as today. “Instead of doing nothing, we have decided to make a dramatic change. We are the only tobacco company whose efforts are squarely focused on replacing cigarettes with smoke-free products as soon as possible, and we are fundamentally transforming our organisation to meet this ambitious objective,” she notes. Gilchrist mentions that they are very clear that their smoke-free products are not risk-free. They contain nicotine, she says, which is addictive but is not the primary cause of smoking-related diseases. Decades of science show that it is the burning – or the combustion – of tobacco that causes the vast majority of the harmful and potentially harmful constituents in tobacco smoke. An impractical choice with hidden risks? “Our goal is to help accelerate the end of smoking worldwide, including Africa. The best choice is to quit altogether, but every adult smoker in the world who doesn’t have access to accurate information about less harmful alternatives. We are committed to doing our part by developing products and business models that make scientifically substantiated smoke-free products accessible to all adult smokers regardless of where they live,” Gilchrist adds. Dynamo Ndacyayisenga, who heads drug abuse prevention and treatment at Rwanda Biomedical Centre reasons that considering the effects of e-cigarettes, they are worse than ordinary ones. E-cigarettes are believed to contain potentially dangerous chemicals. “They also contain nicotine just like ordinary tobacco, and studies show that it’s an addictive substance. Smoking e-cigarettes can be a source of different diseases like lung cancer, shortness of breath and chest pain not forgetting the chemical irritations and allergic reaction to various chemicals,” he warns. The medic explains that consumption of nicotine through e-cigarette is highly addictive and can affect the brain’s development especially for children and youth. E-cigarette use is likely to be the cause of different cancers, it can also be hazardous for it has the ability to cause harm due to acute chronic nicotine poisoning, he adds. “Its use can also cause accidents during its explosion. We are discouraging their consumption for we are sure that e-cigarettes are very bad compared to ordinary tobacco consumption. Its consequences are an addition to those caused by tobacco. In developed countries, they are considered a good option only because of the advertisement done in movies that promotes them,” he says. In terms of stalling the use of these cigarettes in the country, Ndacyayisenga reveals that what RBC does is undertaking preventive measures that inhibits initiation of their use. “We have put it among illicit drugs and categorised it among prohibited drugs in Rwanda. It’s even on the list of drugs in our country. Only traces of people are using it but are very few and do it in a hidden way, for it is punishable by law.” Information from the Healthline website supports Ndacyayisenga’s view as it shows that e-cigarettes contain added flavours that young people enjoy-some of these additives have health risks, such as diacetyl which has a buttery taste. Diacetyl has been found to cause a severe lung disease similar to bronchiolitis and Cinnemaldehyde, which tastes like cinnamon, is another popular vaping flavour that may be harmful to lung tissue. The information also shows that e-cigarettes contain many of the same cancer-causing chemicals that regular cigarettes do. This is because high temperatures needed to form the mist for vaping can create dozens of toxic chemicals such as formaldehyde, which is thought to cause cancer. E-cigarettes have been known to spontaneously explode. This has caused injury. Vape explosions have been linked to faulty batteries in vaping devices. While rare, vape explosions can be very dangerous and can cause severe injury. It’s a myth that e-cigarettes are not dangerous. Any product containing nicotine and toxins has the potential to harm and cause addiction, the website shows.