E-cigarette: Reexamining its Effectiveness and Regulation in Europe

The e-cigarette, once hailed as a smoking cessation tool, may warrant reconsideration as tobacco companies are now advocating for stricter regulations on its usage.

In recent years, the phenomenon of teenagers using e-cigarettes has been spreading across Europe.

Since 2013, the number of teenagers aged 11 to 17 in the UK who have used e-cigarettes has quadrupled. In France, over half of teenagers aged 17 have tried e-cigarettes. In Italy, the proportion of teenagers aged 11 to 17 who have used e-cigarettes in the past month has doubled since 2014, and there has also been a noticeable increase in Latvia and Romania.

While e-cigarettes are widely believed to assist adult smokers in quitting, government officials, doctors, public health experts, and the general public are now sounding the alarm over the increasing use of these products among teenagers. Even the industry itself is calling for stronger regulation.

James Murphy, director of research and science at British American Tobacco (BAT), has stated that the company is willing to take measures to reduce the appeal and accessibility of e-cigarettes to young people.

He stated:

I believe that if we establish these protective measures in our surroundings, it will further redirect the attention of adults who are interested in making a change, while making it less appealing for teenagers whom we do not want to be exposed to these products.

His comments echo those of his boss, Tadeu Marroco, the CEO of British American Tobacco, who earlier this month stated the need for "better regulations" to address the issue of youth vaping.

Since e-cigarettes first entered the market, there has been a significant shift with the emergence of small disposable e-cigarettes in soft colors and cotton candy-like flavors. These e-cigarettes are now easily obtainable from unscrupulous sellers across Europe.

A new reality has prompted people to question whether lawmakers were completely mistaken when they formulated regulations for e-cigarettes a decade ago, and if it is now necessary to amend these rules.

The intense showdown among the legislators, coupled with rumors, threats, and fierce lobbying.

On October 8, 2013, at the European Parliament in Strasbourg, tensions ran high as Linda McAvan, the chief negotiator for the Tobacco Products Directive, called for a "wise and calm" discussion, urging to avoid the "distortions" witnessed in recent weeks.

The topic of the meeting was the proposal by the European Commission to classify the majority of e-cigarettes as medicinal products, which would require them to go through a pharmaceutical authorization process. EU member states have mostly reached a consensus on this issue, but European Parliament members have not yet made a decision.

Lobbyists and avid e-cigarette users are becoming increasingly restless, fueling rumors that Brussels is planning to ban e-cigarettes. The members of parliament have been bombarded with intense lobbying tactics, with some describing the situation as unprecedented within the usual scope of parliamentary proceedings.

McCarthy, a member of the Labour Party in the UK, is also a member of the Social and Democratic Progressive Party. She stated that although the documents primarily address traditional cigarettes, the issue of e-cigarettes has quickly become a major topic of discussion.

It quickly turned into a highly aggressive lobbying campaign," the former Member of the European Parliament told Politico magazine. The CEO of an e-cigarette company was relentless, she said, leaving messages on her phone and sending emails to her, referring to McCawen as his "archenemy." She and her team had considered filing a police report.

In the end, lobbying groups and enthusiastic e-cigarette users successfully persuaded lawmakers that e-cigarettes require lenient regulatory measures.

They are nearly zealous advocates for e-cigarettes," liberal member of parliament Rebecca Taylor remarked to The New York Times, describing herself as "one of several European Parliament members who have been urged by former smokers to embrace the use of e-cigarettes.

Taylor and other members of liberal, European conservative, and European People's Party groups have proposed amendments that would eliminate the requirement for e-cigarettes to undergo medicinal authorization, only requiring authorization if they are claimed to be smoking cessation devices.

The amendment ultimately passed.

Dr. Jørgen Vestbo, a renowned clinical physician and honorary professor of respiratory medicine at the University Hospital of South Manchester in the United Kingdom, has been persistently critical of e-cigarettes. He firmly believes that transforming e-cigarettes into medical products could help prevent numerous issues that have already arisen.

Tidying up the chaos

The focus has shifted from health to attracting young people in the tobacco industry, and European regulations have generally worked well. Murphy describes it as a "fairly pragmatic regulatory framework" that has led many people to switch from smoking to e-cigarettes. He says,

This is why some of the lowest smoking rates in the world have emerged.

However, he also suggested that perhaps the rules should be adjusted to reduce the interest of teenagers in using e-cigarettes.

Murphy stated that BAT is willing to restrict the flavors of e-cigarettes to three categories, such as tobacco, mint, and fruit, while excluding candy and other novelty flavors like alcohol (which requires little effort for BAT as the company currently only offers these three flavor categories).

I believe that standards can be established regarding packaging and formatting, for example, 'these are the acceptable formats' and 'this is the permitted packaging style'.

The transformation has already begun.

The National Anti-Smoking Committee in France has proposed a ban on all flavors, while the then Health Minister, François Braun, expressed support for the prohibition of disposable e-cigarettes in May.

In Germany, the Bavarian government is pushing for a ban on disposable e-cigarettes across the European Union. The country's drug commissioner states that regulating the appearance and packaging of e-cigarettes will help reduce their usage among young people.

In the United Kingdom, the government is not only encouraging companies to seek drug licenses for their products, but it is also planning to introduce new taxes on e-cigarettes. Additionally, there are plans to offer introductory e-cigarette kits to smokers.

At the same time, the European Commission has retained the possibility of stricter e-cigarette regulation in its future revision of the Tobacco Products Directive, stating that further consideration should be given to the need for developing or clarifying regulations regarding the use of flavors and advertising promotions.

As Brussels starts considering the potential revision of regulations, lawmakers who supported the light-touch approach a decade ago now appear to be more open to regulation.

European People's Party MEP Peter Liese supported an amendment in 2013 to halt the categorization of medical products. He maintains an open stance towards implementing stricter regulations for e-cigarettes, including cracking down on the use of flavors.

He also pointed out that it is necessary to evaluate disposable e-cigarettes to determine whether they should continue to be allowed. He stated that the only reason these products exist is to attract those who are unwilling to purchase long-term use devices: "Of course, there is a hope for more children who want to quit smoking than smokers," he said.

Even e-cigarettes could potentially be included in prescriptions and could offer some help, as it would mean the product can be reimbursed, allowing individuals who truly need these products to access them at a lower price, according to Lisa.