EU policy on e-cigarettes is a “dog’s dinner,” says UK regulator

BMJ 2013; 347 doi: (Published 15 November 2013) Cite this as: BMJ 2013;347:f6871
  1. Matthew Limb
  1. 1London

The United Kingdom will continue to press for effective Europe-wide controls on electronic cigarettes because of public health concerns, a senior regulator has said.

Jeremy Mean, group manager of vigilance and risk management of medicines at the UK Medicines and Healthcare Products Regulatory Agency (MHRA), said that there were anecdotal signs that more young people were trying e-cigarettes and that this must be properly monitored for any long term effects.

Concerns have been expressed that e-cigarettes could act as a gateway to tobacco use for young people, although some surveys had shown that use among children was rare and mostly confined to those who were already smoking or had smoked.

Mean also said that many unlicensed e-cigarettes now available today were poorly manufactured or liable to leak their contents or overheat. “We don’t know enough about the safety of these products,” he said.

The MHRA has decided that all e-cigarettes and other electronic products containing nicotine will be regulated as medicines from 2016 to ensure their quality.1 Regulation is also meant to prevent advertising or promotion to non-smokers, including children.

Mean said that the UK was showing leadership in Europe on the issue.

In October the European Parliament voted to reject its health commissioner’s advice that e-cigarettes should be classified as medicines.2 Mean described the current state of European Union policy on e-cigarettes as a “dog’s dinner.”

“It does not amount to a regime capable of protecting and promoting public health,” he said, arguing that stronger controls and enforcement were needed.

Mean said that UK would press for the EU to adopt the right framework to create a “level playing field” for e-cigarettes. He said, “You need regulatory levers and controls to make a system work and make it future proof.”

Mean was speaking at a conference on e-cigarettes at the Royal Society in London on 12 November, organised by the E-cigarette Forum. It was billed as an opportunity for people with different views on e-cigarettes, including users, manufacturers, scientists, policy makers, and researchers, to debate the evidence.

Robert West, professor of health psychology and director of tobacco studies at the charity Cancer Research UK, said, “If smokers switched today to e-cigarettes you would save millions of lives.”

But he said that the key question was how that goal could be realised, and he backed the MHRA’s call for proportionate regulation.

Experts on public health have said that this would ensure that e-cigarettes were treated in the same way as nicotine replacement therapies, such as gum and patches, so that safe, effective, and “useful” products would be widely available.

West said that data showed that the main reason why people adopted e-cigarettes was to stop smoking and that there had been a “meteoric rise” in this in recent years. “One in three quit attempts in England involve the use of e-cigarettes—that’s quite an astonishing transformation in a short period of time,” he said.

Lynne Dawkins, lecturer in psychology at the University of East London, said that e-cigarette technology was developing at an “unprecedented” rate and that design innovations now allowed people to customise or “pimp” their devices.

Konstantinos Farsolinos, a researcher at the Onassis Cardiac Surgery Centre in Greece, said that there was no reason for non-smokers to use e-cigarettes. “However small the risk, there is no reason to adopt the habit,” he said. He said that more research should be carried out into the materials used in e-cigarettes.

Clive Bates, a public health commentator and former head of the charity Action for Smoking on Health, said that the growing take-up of e-cigarettes represented a massive public health opportunity. But it could be ruined by heavy handed regulation that would make products less appealing, more “boring,” and harder to come by, as only big tobacco companies could meet the barriers to market entry and bear the costs of compliance, he said.

Bates said that e-cigarettes should be marketed like cosmetics, not drugs. “We shouldn’t become obsessed with the relatively minor risks,” he said.


Cite this as: BMJ 2013;347:f6871


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