Teen vaping: Did the EU get it wrong on e-cigarettes?

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When the head of a tobacco company is calling for stricter regulation on its e-cigarettes, you know there must be something wrong.

In recent years, across Europe, teen vaping has exploded. The number of 11-17 year olds who have ever used an e-cigarette has quadrupled in the U.K. since 2013; more than half of 17-year-olds in France have tried a vape; and the percentage of 11-17 year olds who have used an e-cigarette in the past month has doubled in Italy since 2014 and increased significantly in Latvia and Romania.

While there’s broad, if not universal, agreement that e-cigarettes can help adult smokers quit, governments, doctors, public health experts and the public are now sounding the alarm on the increase in young people using these products. Even industry is calling for stricter rules.

James Murphy, director of research and science at British American Tobacco (BAT), told POLITICO the company was open to options to make e-cigarettes less appealing and accessible for young people. “I think if we start to put those guardrails around it, you really start to, I think, focus it towards adults who want to switch and it’s then less appealing to youth who we don’t want anywhere near these products,” he said. 

His comments follow those of his boss, BAT’s Chief Executive Tadeu Marroco, who earlier this month said there needs to be “better regulations” to address youth vaping.

The landscape has dramatically changed since vapes first burst onto the market, with the emergence of tiny disposable e-cigarettes in pastel colors and in flavors such as candyfloss, readily available for teenagers from unscrupulous sellers around Europe.

And the new reality has led to questions about whether lawmakers got it all wrong a decade ago when they set out the rules regulating e-cigarettes — and whether those rules should now be revised.

Rumors, threats and aggressive lobbying

It was October 8, 2013 in the European Parliament in Strasbourg and the room was highly charged. The lead negotiator on the Tobacco Products Directive, Linda McAvan, was calling for a “sensible, calm” debate, without the “misrepresentations we have seen in recent weeks.”

The meeting was to discuss the European Commission’s proposal to regulate most e-cigarettes as medical products, which would mean they would need to go through the medicine authorization process. EU countries were in agreement, but MEPs were still undecided.

Lobbyists and avid vapers were circling, with false rumors being spread that Brussels planned to ban e-cigarettes. MEPs were being bombarded with aggressive lobbying tactics, described at the time as beyond anything usually seen in the parliament. 

McAvan, from Britain’s Labour Party and a member of the S&D group, said that while the file was mainly focused on tobacco cigarettes, the issue of e-cigarettes quickly became one of the central issues.

“It became a very, very aggressive lobby, very quickly,” the former MEP told POLITICO. One owner of an e-cigarette company hounded McAvan, she said, leaving messages on her phone and emailing her, describing McAvan as his “nemesis.” She and her team considered going to the police. 

The number of 11-17 year olds who have ever used an e-cigarette has quadrupled in the U.K. since 2013 | Christopher Furlong/Getty Images
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Ultimately, that lobby, alongside an active group of vape users, convinced MEPs that e-cigarettes needed a light touch.

“They are almost evangelical about e-cigarettes,” Liberal MEP Rebecca Taylor told the New York Times at the time, where she was described as “one of many members of the European Parliament swayed by the appeals of former smokers who switched to e-cigarettes.”

Taylor, alongside other MEPs in the Liberal, ECR and EPP groups, proposed an amendment removing the requirement for e-cigarettes to be authorized as medical products, except where they claimed to be smoking cessation devices.

It passed. 

Jørgen Vestbo, a clinician and emeritus professor of respiratory medicine at the University Hospital of South Manchester — and a long-time critic of e-cigarettes —believes making them into medical products would have prevented many of the problems that have emerged. “In hindsight, yes, we should have put it on prescription,” he said. But doing that now? Vestbo admits that’s a more difficult task.

Cleaning up the mess

As far as the tobacco industry is concerned, the rules that Europe ended up with generally work well. Murphy described them as “quite a pragmatic regulatory framework,” which has resulted in a strong migration from smoking to e-cigarettes. “And that’s why you’re seeing some of the lowest smoking rates we’ve ever seen in the world,” he said.

But, perhaps mindful of the direction of political winds, he also said they could be tweaked to discourage teen vaping. BAT would be happy for flavors to be limited to, for example, three categories — tobacco, menthol and fruit, with confectionery and other novelty flavors like alcohol ruled out, he said. (That wouldn’t take much effort for BAT, which currently only has those three flavor categories).

“I think there can be standards around things like packaging and formats, and say, ‘OK, these are the formats that are permitted. This is the style of packaging that is permitted,’” said Murphy.

Change is in the works. France’s national committee against smoking has recommended a ban on all flavors and the then health minister François Braun said in May that he was in favor of a ban on disposable e-cigarettes. 

In Germany, the Bavarian government is pushing for an EU-wide ban on disposable vapes and the country’s drug czar has said regulating the appearance of e-cigarettes and their packaging would help decrease use among young people. 

Across the Channel, the U.K. is looking at a new tax on vaping, while also pushing companies to apply for medical licenses for their products, as it announces plans to hand out vape starter kits to smokers. 

Meanwhile, the Commission has kept the possibility of more stringent e-cigarette regulation in a future revision of the Tobacco Products Directive, saying in a report that it should be explored whether provisions around the use of flavors and advertising promotion should be “further developed or clarified.”

Governments, doctors, public health experts and the public are now sounding the alarm on the increase in young people using e-cigarettes | Joel Saget/AFP via Getty Images

And as Brussels looks into a possible rewrite of its own rules, MEPs who supported the light touch approach a decade ago, seem more open to regulation.

EPP MEP Peter Liese, who backed the 2013 amendment stopping the medical product classification, told POLITICO he’s open to more stringent rules around e-cigarettes, including clamping down on flavors.

He also pointed to the need to assess disposable e-cigarettes to see if these should still be allowed, saying that the only reason they are around is to attract people that are not willing to buy the equipment for long-term use: “Of course it’s logical that it’s more children than smokers that want to quit [who are using them],” he said.

Even the possibility of having e-cigarettes on prescription could potentially be helpful as it would mean the products could be reimbursed, making them cheaper for those who really need them, said Liese.