EU vote on draft Tobacco Directive supports electric cigarette use

European MEPs have voted against tighter restrictions on the selling and use of electronic cigarettes

after the UK called for more regulation.

The rise in popularity of electronic cigarettes has alarmed the tobacco industry as well as some health experts, who have called for more research into the potentially harmful effects of the vapour used to deliver nicotine in e-cigarettes.

Many European governments have also moved to restrict sales or use of e-cigs including the Italian government, which earlier this year called for a restriction on selling e-cigarettes to under-18s until further research into safety had been carried out. In July this year the Italian government decided to impose a tax on electronic cigarettes to bring them into line with tobacco products. This means that in Italy, people who switch to e-cigarettes will not enjoy the savings many smokers who quit tobacco experience. The move has added around 20 euros to the price of a basic e-cig starter kit in Italy, while the cost of more sophisticated e-cigarette kits will rise by around 50 euros in Italy.

The UK government has expressed fears that electronic cigarettes might act as a gateway to smoking tobacco, especially among minors and young adults. However, earlier this year, the NHS approved electronic cigarettes for use as a smoking cessation aid. Many smokers also claim they would not have been able to quit smoking without the help of electronic cigarettes, which offer the nearest experience to actually smoking tobacco currently available.

E-cigarettes comprise a barrel shaped like a cigarette or cigar, to which a cartomiser containing liquid nicotine is attached. The battery-operated electronic cigarette heats up on use, with the tip turning red thanks to an LED bulb. The heat also turns the nicotine liquid in the cartomiser to vapour, which the smoker inhales. However, the levels of harmful chemicals which tobacco produces, such as carbon monoxide and other cancer causing agents, are reduced to a minimum in e-cigarettes.

Electronic cigarettes also produce no smoke or tar as tobacco products do. Tar from cigarettes coats the linings of lungs and other organs and raises the risk of developing cancers such as lung cancer. Around 6 million people die every year as a result of tobacco-related disease worldwide, but there has yet to be recorded a death related to electronic cigarette use in the 10 years they have been available.

The nicotine level in an electronic cigarette can also be controlled as the cartomisers (refills) are available in different strengths, ranging from zero nicotine to 36g. Each cartomiser would contain around one-tenth of the stated level, however, as the nicotine level is measured in milligrammes per litre (ie 36g per litre would mean the actual dose offered in a cartomiser would be 3.6g).

The Italian government is concerned, however, that the actual level of nicotine delivered in each cartomiser might be higher than advertised, meaning people who use electronic cigarettes to quit tobacco might actually be inhaling higher doses of nicotine than they think they are. In the UK, the Department of Health had called for electronic cigarettes to be viewed in the same way as tobacco products with restrictions on sales and use, including prohibiting the use of e-cigarettes in enclosed public places.

The UK Medicines and Healthcare products Regulatory Agency (MHRA) has also supported regulation of electronic cigarettes to enable safety checks to be made on their use and content. However, being able to use an electronic cigarette socially without restriction is one of the many benefits ex-smokers have enjoyed when trying to quit. The ban on smoking tobacco in public was brought in in the UK in 2007, meaning smokers now have to stand outside offices or smoke on pavements and many have pointed out that this means passersby including children still inhale harmful tobacco smoke.

Currently it is legal for vapers (the name given to those who use electronic cigarettes) to use e-cigs in public places, vehicles and bars and restaurants, but it is likely that the UK government will continue its fight to regulate their use in the same way as tobacco products. The EU vote on 8 October was on stage one of the draft European Tobacco Directive, which could become law as early as 2014. The European elections in May 2014 have placed pressure on the EU Parliament to obtain a consensus between EU member states on the legislation, which if passed could be rolled out across Europe by 2016.

Tobacco companies have also been lobbying for tighter restrictions on electronic cigarettes and even on e-cigarette packaging. Currently tobacco products have to carry graphic public health warnings and some tobacco manufacturers claim that this puts their products at a disadvantage compared with electronic cigarette brands. Leading cigarette manufacturers have even entered the e-cigarette market themselves in response to the growing popularity of e-cigs among ex-smokers trying to give up.

The EU Parliament vote on 8 October also coincides with the NHS Stoptober initiative in the UK, which encourages smokers to quit for 28 days. It is thought that smokers who stay tobacco-free for 28 days have a five-times improved chance giving up tobacco for good. The 2013 Stoptober campaign is due to end on 28 October and it is likely many of those taking part in Stoptober this year and trying to quit tobacco will be using electronic cigarettes for the first time.

UK campaigners calling for more regulation of e-cigarettes have also questioned the use of fruit and other flavourings used in nicotine cartomisers, however, which they argue might make e-cigarettes more attractive to nonsmokers or even children. However, some UK MEPS came out in favour of electronic cigarettes and acknowledged their benefit to smokers trying to quit.
Liberal democrat MEP Chris Davies said that electronic cigarettes were potentially a “game changer” for many smokers trying to quit tobacco products; while Conservative MEP Martin Callanan said “forcing” e-cigarettes “off the shelves” would have been “totally crazy”.

The MHRA issued a statement on its website following the vote:

“The MHRA continues to believe that medicinal regulation of nicotine containing products is in the best way to deliver a benefit to public health.
“We will be continuing to encourage companies voluntarily to seek a licence for their products so that they can be seen to meet appropriate standards of safety, quality and efficacy and could be sold and supplied, including on prescription, according to the NICE public health guidance on reducing the harms of smoking. “