Purpose of Review
Jurisdictions around the world have adopted different policies in order to regulate e-cigarette products, to allow for the use of e-cigarettes by cigarette smokers for cessation or harm reduction and to reduce the likelihood of non-smokers initiating e-cigarette use. The purpose of this review is to provide a brief overview of different e-cigarette regulations across the world, focusing on regulations of sales, product standards, nicotine concentrations, flavours and marketing restrictions. This review was conducted between February and April 2020.
There are a large range of policies that countries around the world have chosen in order to regulate vaping products to prevent use and limit harm associated with use of e-cigarettes. Many countries provide avenues for separate regulation of therapeutic and consumer e-cigarette devices.
E-cigarettes have the potential of causing harm among young vapers and reducing harm among adult cigarette smokers. The most effective strategies would balance both of these properties and prevent access to vaping products among adolescents and youths and at the same time increase the availability of the regulated therapeutic products among people trying to quit smoking. Future efforts of research should focus on evaluating the impact of different regulatory policies to achieve these purposes and exploring the use of e-cigarettes as a smoking cessation aid. Our recommendations are based on existing literature on the effectiveness of current e-cigarette regulations.
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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
• Hammond D, Rynard VL, Reid JL. Changes in prevalence of vaping among youths in the United States, Canada, and England from 2017 to 2019. JAMA Pediatr. Published online May 04, 2020;e2009001. doi:https://doi.org/10.1001/jamapediatrics.2020.0901. Recent cross-country trends in prevalence of vaping among youths.
Centers for Disease Control and Prevention. Quick facts on the risks of e-cigarettes for young people [Internet]. CDC; 2020 [cited 2020 May 4]. Available from: https://www.cdc.gov/tobacco/basic_information/e-cigarettes/Quick-Facts-on-the-Risks-of-E-cigarettes-for-Kids-Teens-and-Young-Adults.html
• National Academies of Sciences, Engineering, and Medicine. Public health consequences of e-cigarettes. Washington, DC: National Academies Press (US); 2018. doi:https://doi.org/10.17226/24952. Comprehensive summary of scientific evidence on e-cigarette toxicity and health effects.
Smith RF, McDonald CG, Bergstrom HC, Ehlinger DG, Brielmaier JM. Adolescent nicotine induces persisting changes in development of neural connectivity. Neurosci Biobehav Rev. 2015;55:432–43.
• National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. Preventing tobacco use among youth and young adults: a report of the Surgeon General [Internet]. Atlanta (GA): Centers for Disease Control and Prevention (US); 2012 [cited 2020 May 4]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK99237/. Comprehensive summary of health effects of tobacco use among youths and evidence-based preventive approaches.
•• World Health Organization. WHO report on the global tobacco epidemic 2019: offer help to quit tobacco use [Internet]. WHO [cited 2020 May 3]. Available from: https://www.who.int/publications-detail/who-report-on-the-global-tobacco-epidemic-2019-offer-help-to-quit-tobacco-use. Provides comprehensive policy suggestions for countries to regulate e-cigarettes.
Gravely S, Driezen P, Ouimet J, Quah ACK, Cummings KM, Thompson ME, et al. Prevalence of awareness, ever-use and current use of nicotine vaping products (NVPs) among adult current smokers and ex-smokers in 14 countries with differing regulations on sales and marketing of NVPs: cross-sectional findings from the ITC Project. Addiction. 2019;114(6):1060–73.
US Food and Drug Administration. Vaporizers, e-cigarettes, and other electronic nicotine delivery systems (ENDS) [Internet]. FDA; 2020 [cited 2020 Apr 29]; Available from: https://www.fda.gov/tobacco-products/products-ingredients-components/vaporizers-e-cigarettes-and-other-electronic-nicotine-delivery-systems-ends
Australian Government Department of Health. About e-cigarettes [Internet]. [cited 2020 May 11]. Available from: https://www.health.gov.au/health-topics/smoking-and-tobacco/about-smoking-and-tobacco/about-e-cigarettes
•• Institute for Global Tobacco Control. Country laws regulating e-cigarettes: a policy scan [Internet]. Baltimore, MD: Johns Hopkins Bloomberg School of Public Health [cited 2020 Apr 28]. Available from: https://www.globaltobaccocontrol.org/e-cigarette_policyscan. Summary of global e-cigarette regulatory policies by country.
Health Canada. Vaping product regulation [Internet]. aem. 2020 [cited 2020 Apr 29]. Available from: https://www.canada.ca/en/health-canada/services/smoking-tobacco/vaping/product-safety-regulation.html
New Brunswick Anti-tobacco Coalition. Cross-Canada update: e-cigarettes and vaping products legislation [Internet]. NBATC; 2019 [cited 2020 May 3]. Available from: http://nbatc.ca/2020/01/13/cross-canada-update-e-cigarettes-and-vaping-products-legislation/
Council of the European Union, European Parliament. Directive 2014/40/EU of the European Parliament and of the Council of 3 April 2014 on the approximation of the laws, regulations and administrative provisions of the member states concerning the manufacture, presentation and sale of tobacco and related products and repealing Directive 2001/37/EC. Off J Eur Union. 2014;L127:1–38.
Government of UK. E-cigarettes and vaping: policy, regulation and guidance [Internet]. GOV.UK. [cited 2020 Apr 29]. Available from: https://www.gov.uk/government/collections/e-cigarettes-and-vaping-policy-regulation-and-guidance
Global Regulation. Tobacco business act (Republic of Korea) [Internet]. [cited 2020 Apr 29]. Available from: https://www.global-regulation.com/law/korea/644061/tobacco-business-act.html
• Public Health Law Center. U.S. e-cigarette regulations - 50 state review (2020) [Internet]. [cited 2020 Apr 29]. Available from: https://www.publichealthlawcenter.org/resources/us-e-cigarette-regulations-50-state-review. Summary of e-cigarette regulatory policies in the states of the US.
US Food and Drug Administration. Selling tobacco products in retail stores. [Internet]. FDA; 2020 [cited 2020 Apr 29]; Available from: https://www.fda.gov/tobacco-products/retail-sales-tobacco-products/selling-tobacco-products-retail-stores
Iceland Ministry of Welfare. Act on electronic cigarettes and refill containers for electronic cigarettes, No. 87/2018. :5 [Internet]. Iceland Ministry of Welfare. [cited 2020 May 10]. Available from: https://www.tobaccocontrollaws.org/files/live/Iceland/Iceland%20-%20E-Cigs%20Act%20%28No.%2087_2018%29.pdf
Legifrance. Authenticated electronic version published in OJ n ° 0116 of 05/20/2016 [Internet]. Legifrance. [cited 2020 May 10]. Available from: https://www.legifrance.gouv.fr/jo_pdf.do?id=JORFTEXT000032547462
Truth Initiative. E-cigarettes: facts, stats and regulations [Internet]. Truth Initiative. [cited 2020 May 9]. Available from: https://truthinitiative.org/research-resources/emerging-tobacco-products/e-cigarettes-facts-stats-and-regulations
Goniewicz ML, Gupta R, Lee YH, Reinhardt S, Kim S, Kim B, et al. Nicotine levels in electronic cigarette refill solutions: a comparative analysis of products from the US, Korea, and Poland. Int J Drug Policy. 2015 Jun;26(6):583–8.
US Food and Drug Administration. Flavors in tobacco products: what are the potential risks and benefits to public health? [Internet]. FDA; 2020 [cited 2020 Jul 26]; Available from: https://www.fda.gov/tobacco-products/products-ingredients-components/flavors-tobacco-products-what-are-potential-risks-and-benefits-public-health
Ollila E See you in court: obstacles to enforcing the ban on electronic cigarette flavours and marketing in Finland. Tob Control Published online 2019. doi: https://doi.org/10.1136/tobaccocontrol-2019-055260, tobaccocontrol-2019-055260.
Tobacco Control Laws. Legislation [Internet]. [cited 2020 May 3]. Available from: https://www.tobaccocontrollaws.org/legislation
Humber N. Denmark flavour ban plan could spread across Europe. Ecigclick [Internet]. 2020 [cited 2020 May 19]. Available from: https://www.ecigclick.co.uk/denmark-flavour-ban-plan/
European Commission. Draft act amending the Tobacco Act [Internet]. European Commission: Search the database. [cited 2020 May 19]. Available from: https://ec.europa.eu/growth/tools-databases/tris/en/search/?trisaction=search.detail&year=2016&num=648
US Food and Drug Administration Newsroom. FDA finalizes enforcement policy on unauthorized flavored cartridge-based e-cigarettes that appeal to children, including fruit and mint [Internet]. FDA; 2020 [cited 2020 May 3]. Available from: https://www.fda.gov/news-events/press-announcements/fda-finalizes-enforcement-policy-unauthorized-flavored-cartridge-based-e-cigarettes-appeal-children
Fitzgerald K, Chan-Green M. Government looking at banning most flavours of vape liquid, would only allow three. Newshub [Internet]. 2019 [cited 2020 May 10]; Available from: https://www.newshub.co.nz/home/politics/2019/09/government-looking-at-banning-most-flavours-of-vape-liquid-would-only-allow-three.html
Government of Ontario Newsroom. Ontario protecting children and youth from dangers of vaping [Internet]. Ontario Newsroom; 2020 [cited 2020 May 10]. Available from: https://news.ontario.ca/mohltc/en/2020/02/ontario-protecting-children-and-youth-from-dangers-of-vaping.html
• World Health Organization. European tobacco use: trends report 2019 [Internet]. WHO [cited 2020 May 9]. Available from: http://www.euro.who.int/__data/assets/pdf_file/0009/402777/Tobacco-Trends-Report-ENG-WEB.pdf?ua=1&ua=1. Analytic projection of trends of tobacco products use and related policies in Europe.
• World Health Organization Regional Office for Europe. EUR/RC65/10 Roadmap of actions to strengthen implementation of the WHO Framework Convention on Tobacco Control in the European Region 2015–2025: making tobacco a thing of the past [Internet]. [cited 2020 May 9]. Available from: http://www.euro.who.int/__data/assets/pdf_file/0011/282962/65wd10e_Tobacco_150475.pdf?ua=1. Guidelines for WHO European Region for reducing tobacco use prevalence.
New Zealand Legislation. Smoke-free environments and regulated products (vaping) amendment bill 222–1 (2020), government bill explanatory note. [Internet]. New Zealand Legislation. [cited 2020 May 9]. Available from: http://legislation.govt.nz/bill/government/2020/0222/latest/d1393751e2.html
Physicians for a Smoke-free Canada. At-a-glance: restrictions on vaping product marketing in Canada. May 2020 [Internet]. [cited 2020 May 9]. Available from: http://www.smoke-free.ca/SUAP/2020/vaping-regulation.pdf.
Health Canada. Summary of results for the Canadian student tobacco, alcohol and drugs survey 2018-19 [Internet]. aem. 2019 [cited 2020 May 4]. Available from: https://www.canada.ca/en/health-canada/services/canadian-student-tobacco-alcohol-drugs-survey/2018-2019-summary.html
Tanski S, Emond Phd J, Phd CS, Kirchner T, Choi K, Yang L, et al. Youth access to tobacco products in the United States: findings from wave 1 (2013-2014) of the Population Assessment of Tobacco and Health Study. Nicotine Tob Res. 2019;21(12):1695–9.
American Lung Association. Tobacco 21 laws: raising the minimum sales age for all tobacco products to 21 [Internet]. American Lung Association; 2019. [cited 2020 May 19]. Available from: /policy-advocacy/tobacco/prevention/tobacco-21-laws
• Doan TTT, Tan KW, Dickens BSL, Lean YA, Yang Q, Cook AR. Evaluating smoking control policies in the e-cigarette era: a modelling study. Tob control. Published online 2019. https://doi.org/10.1136/tobaccocontrol-2019-054951. Provides e-cigarette policy recommendations for reducing smoking prevalence.
• Zare S, Nemati M, Zheng Y. A systematic review of consumer preference for e-cigarette attributes: flavor, nicotine strength, and type. PLoS One. 2018;13(3):e0194145 Recent systematic review of flavour influence on e-cigarette initiation and using as a cessation aid among youths, young adults and adults.
Shang C, Huang J, Chaloupka FJ, Emery SL. The impact of flavour, device type and warning messages on youth preferences for electronic nicotine delivery systems: evidence from an online discrete choice experiment. Tob Control. 2018;27(e2):e152–9.
Hoffman AC, Salgado RV, Dresler C, Faller RW, Bartlett C. Flavour preferences in youth versus adults: a review. Tob Control. 2016;25(Suppl 2):ii32–9.
Statistics Canada. Canadian Tobacco and Nicotine Survey, 2019 [Internet]. Statistics Canada; 2020 [date accessed 2020 Jul 27]. Available from: https://www150.statcan.gc.ca/n1/daily-quotidien/200305/dq200305a-eng.htm
• Lovato C, Watts A, Stead LF. Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours. Cochrane Database Syst Rev. 2003;(4):CD003439. https://doi.org/10.1002/14651858.CD003439. Systematic review on initiation of smoking upon exposure to tobacco advertising and promotion.
• Robertson L, Cameron C, McGee R, Marsh L, Hoek J. Point-of-sale tobacco promotion and youth smoking: a meta-analysis. Tob Control. 2016;25(e2):e83–9 Meta-analysis on relationship between tobacco smoking among adolescents and children and point-of-sale tobacco promotion.
Saffer H, Chaloupka F. The effect of tobacco advertising bans on tobacco consumption. J Health Econ. 2000;19(6):1117–37.
Blecher E. The impact of tobacco advertising bans on consumption in developing countries. J Health Econ. 2008;27(4):930–42.
• Institute of Medicine (US) Committee on Preventing Nicotine Addiction in Children and Youths. Growing up tobacco free: preventing nicotine addiction in children and youths. Washington: National Academies Press (US); 1994. https://doi.org/10.17226/4757. Summarized policies and guidelines for preventing tobacco use among children and youths.
Funding for this review was received from Physicians for Smoke-Free Canada and Health Canada Substance Use and Addictions Program.
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Klein, D.E., Chaiton, M., Kundu, A. et al. A Literature Review on International E-cigarette Regulatory Policies. Curr Addict Rep 7, 509–519 (2020). https://doi.org/10.1007/s40429-020-00332-w