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Call To Action

E-cigarettes should be regulated in such a way as to reduce smoking of combusted tobacco products to the greatest extent possible.

Electronic cigarettes, also known as e-cigarettes or electronic nicotine delivery systems, were introduced to the market by Chinese entrepreneurs in 2004 and have skyrocketed in awareness, use, and controversy over the past decade. E-cigarettes represent a booming industry, estimated at USD2.5 billion in the USA in 2014.

E-cigarettes mimic traditional cigarettes in design and are often assumed to be “safer” than traditional cigarettes, or to help smokers quit. While these health claims are implied, they are not usually stated explicitly, as this might trigger additional regulation.

Many governments, organizations, companies and consumers are uncertain how e-cigarettes should be regulated. E-cigarettes deliver nicotine, and their health effects are unknown; yet they are assuredly less harmful than traditional tobacco products that burn tobacco. Tobacco companies recognize the potential of this growing market and are investing heavily in e-cigarette brands.

On an individual level, e-cigarettes are likely less harmful to a user than traditional cigarettes, but additional research is needed about the effects of e-cigarettes, long-term consequences of use, and ingredients. Public health experts are concerned that e-cigarette use could renormalize smoking, delay or prevent cessation attempts, promote youth use, and draw former smokers back into nicotine addiction. Additionally, this booming industry is increasingly run by tobacco companies – the same companies that have long promoted dangerous products over consumer health. On the other hand, many believe that e-cigarettes represent the best hope for a disruptive technology that can begin the end of traditional smoking, saving millions of lives.

Currently, there is a significant focus on e-cigarettes and much research is underway to determine health impacts and help inform regulations. For now, this multi-billion dollar industry continues to grow as more people use e-cigarettes out of curiosity, a desire to quit smoking, or a safer way to continue a nicotine addiction.

Prevalence & Use

E-cigarette prevalence and use as a cessation aid in 27 European Countries, 2012

In a 2012 survey of 27 European countries, 20.3% of all current smoker respondents had ever used e-cigarettes, and 3.7% had used them as a cessation aid.

USA E-Cig Regulation

E-cigarette concerns & implications for policy


Initiation doubled in one year.
Implement minimum age of purchase laws.

Most e-cig users continue to smoke, although some may quit completely.
Discourage long-term dual use.

Returning to “safe” nicotine may be attractive to former smokers (potential relapse to smoking).
Restrict marketing targeted
at ex-smokers (e.g. “Welcome Back” campaign).

Companies are advocating e-cigs be used anywhere to increase their acceptance and use.
Regulate vaping in indoor areas so that it does not undermine existing clean indoor air laws.

Upsurge in calls to poison control centers for children under 6 years from liquid nicotine poisoning.
Require child-proof packaging
and appropriate labelling of
liquid nicotine.

E-cigs are being used for other drugs, particularly hash oil.
Consider regulating e-cigs as drug delivery devices, or even as drugs (like nicotine replacement therapy), to allow for possible future health claims.

In 2013, U.S. business analyst Bonnie Herzog predicted that e-cigarette sales in the U.S. will reach $10 billion by 2017.

E-Cigarette Mechanics

How does an e-cigarette work?


are battery-powered devices that resemble cigarettes and heat liquid nicotine, producing a vapor that is inhaled.


function similarly as e-cigarettes but have larger atomizers, batteries and nicotine cartridges, or tanks. Users are able to add different concentrations of liquid nicotine to tank systems resulting in varying, and typically higher, doses of nicotine delivery.

“We’re trying to bring back the chic attitude, THE SEXINESS IN SMOKING.” –Oliver Girard, Chief Executive of Smarty Q E-Cigarettes, 2013

Nearly 48% of U.S. adult e-cigarette users have used combustible cigarettes and e-cigarettes on the same day.

Dual use of e-cigarettes and traditional cigarettes is a public health concern, as SMOKERS COULD BE EXPOSED TO EVEN HIGHER AMOUNTS OF NICOTINE.



Majeed B, Eriksen M, Whitney C. GSU HealthStyles questions on E-Cigarettes, Snus and Dissolvables. (Unpublished raw data.). 2012;

E-Cigarette Marketing Concerns

Marketing in the absence of regulation resembles traditional cigarette advertising

“There is ongoing debate within the nicotine and tobacco research community concerning whether electronic cigarettes WILL OFFER A WAY OUT OF THE SMOKING EPIDEMIC OR A WAY OF PERPETUATING IT. Robustly designed, implemented and accurately reported scientific evidence will be the best tool we have to help us predict and shape which of these realities transpires.” –Sara Hitchman, Ann McNeill & Leonie Brose, Editorial in Addiction, 2014

The Varying State of E-Cigarettes Worldwide

“The World Health Organization reckons that of the one billion smokers globally, 80% live in low- & middle-income countries, most of which are markets that HAVE NOT YET BEEN PENETRATED BY E-CIGS.”

-Derek Yach, SVP & Executive Director of Vitality Institute, 2014

As of January 2014, there were more than 7700 E-CIGARETTE FLAVORS AVAILABLE, with approximately 200+ new flavors being introduced monthly.

The Varying State of E-Cigarettes Worldwide: USA

90% OF US ADULTS were aware of e-cigarettes in a 2014 survey.



Georgia State University Tobacco Center for Regulatory Science. Georgia State University Tobacco Center of Regulatory Science (GSU TCORS) 2014 Tobacco Products and Perceptions Survey (Unpublished Data). 2014.

The Varying State of E-Cigarettes Worldwide: EU

By May 2016, all 28 European Union Member States will regulate e-cigarettes as part of the EU Tobacco Products Directive. Manufacturers will be required to disclose all ingredients and toxicological data, and also provide a description of the production process. Additionally, the amount of nicotine in e-cigarettes and refill containers will be limited, products will be required to carry health warnings, and E-CIGARETTE ADVERTISING WILL BE BANNED.

Approximately 2.1 million adults in Great Britain use e-cigarettes. Of these, about 700,000 are ex-smokers, while

E-CIGARETTE SALES GREW BY 478% in 2013, generating €7.3 million in revenue, while tobacco sales dropped 6%

In 2013, the French HEALTH MINISTER PROPOSED A BAN ON E-CIGARETTE USE. 88% of French survey respondents were aware
of e-cigarettes, and one in five had used e-cigarettes at least once.

The Varying State of E-Cigarettes Worldwide: Asia

Despite manufacturing 95% of the world’s e-cigarettes in Shenzhen, China, e-cig use in the country is very small. In 2013, Smoore, a Chinese e-cigarette manufacturer, SHIPPED MORE THAN 100 MILLION E-CIGARETTES TO OTHER COUNTRIES, primarily Europe and the USA.

In Singapore, the importation, distribution and SALE OF E-CIGS IS PROHIBITED and carries a fine up to $5000 Singapore dollars.

“There’s an unavoidable logic here that eventually no one will smoke regular tobacco on this planet.” –Shane MacGuill, London-based tobacco analyst at Euromonitor, 2014

The Varying State of E-Cigarettes Worldwide: Australia

BY LAW, LIQUID NICOTINE IS CONSIDERED A POISON in Australia and the retail sale of liquid nicotine is allowable only by permit.

The Varying State of E-Cigarettes Worldwide: UAE

United Arab Emirates
The UAE Ministry of Health BANNED E-CIGARETTE USE throughout UAE nations due to health concerns.

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Nicotine Delivery Systems

Because nicotine is not a benign drug, products containing nicotine need to be regulated in a manner commensurate with the harm that they cause.

Tobacco Companies

Tobacco companies should be strictly regulated in ways that minimize the harm caused by their products.