The Tobacco Products Directive being considered by the European Parliament on Wednesday 26th February 2014 includes a proposed ban on all e-cigarettes containing more than 20mg/ml nicotine. According to independent research, this equates to less than 1/3 of the nicotine absorbed through tobacco smoking and some 25% of Europe’s 10 million e-cigarette users currently use higher strengths. These 2.5 million users are also typically the most heavily dependent smokers or ex- smokers. They will face a choice under this ban of using other nicotine sources (such as lower strength e-cigarettes, gum or patches), quitting through will power alone or returning to tobacco smoking. Since weaker e-cigarettes have not satisfied this group’s needs and most have failed to quit using other methods, a significant fraction will return to tobacco use.
The ban compromises e-cigarettes’ role in supporting successful smoke cessation. Our forecast is that the proposed regulation will lead to 210,000 less Europeans successfully quitting smoking each year. Among smokers that are not necessarily in the process of quitting there are those who use e-cigarettes for smoking reduction. Here the effect will be a 0.8% increase in tobacco smoking or the equivalent of an extra 9.6 million cigarettes being smoked each day across the EU.
Standard mortality tables indicate that one half of long-term cigarette smokers are killed by their habit. Our forecast would therefore be that the proposed ban will result in an additional 105,000 deaths every year across Europe.
While more research is needed in this area it is clear that the data that does exist makes it very likely that a ban on such a widely used alternative to smoking tobacco will have a very serious negative impact on public health. It is the responsibility of those who support such a ban to demonstrate what evidence they have to support it.
