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E-cigarettes and the marketing push that surprised everyone

BMJ 2013; 347 doi: (Published 26 September 2013) Cite this as: BMJ 2013;347:f5780
  1. Martin McKee, professor of European public health
  1. 1London School of Hygiene and Tropical Medicine
  1. martin.mckee{at}

Ongoing debate in Europe over regulation may favour the interests of the industry

Many important conversations at the European Regional Committee of the World Health Organization take place in the corridors. This year, at its meeting in Izmir, Turkey, a common topic was the dramatic rise in the marketing of e-cigarettes now being seen in many countries. Where they are allowed, advertisements seem to be appearing everywhere. New outlets are also appearing, in some cases beside schools, as in Slovenia. Governments that had imposed restrictions have been coming under pressure to relax them from manufacturers and, in some cases, from groups portraying e-cigarettes as an effective means of harm reduction.

Many in Izmir wondered whether this intense activity was confined to their own country, but it was soon clear that this was something affecting all of Europe. But why now? The e-cigarette, a battery powered device designed to mimic smoking and to deliver a dose of nicotine without many nasty cancer producing substances in conventional cigarettes, has been around for a long time. The first patent was in 1963, and China has been exported e-cigarettes since 2005. Nobody had seen the big marketing push coming. What has changed?

As we discussed the various experiences the answer emerged. When e-cigarettes first became available the big tobacco companies ignored them, as they thought they …

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