European lawmakers endorsed a permissive approach to the sale and use of e cigarettes, although the products could not be sold legally to anyone younger than 18.

The Food and Drug Administration in the United States has said it wants to issue regulations on the nicotine delivery devices soon. Industry leaders and public health officials had expected them by the end of October but the regulations may be delayed because of the partial government shutdown that has emptied F.D.A. offices.

The electronic cigarette measure in Europe was widely watched because the use of e cigarettes, primarily by smokers seeking a way to kick the tobacco habit, has skyrocketed in Europe and the United States. Instead of smoke from burning tobacco, users ingest the nicotine in the form of vapors from a heated fluid an alternative to smoking commonly called vaping.

The advent of vaping has removed some of the stigma of tobacco use, and in some cases people can use e cigarettes in places where smoking tobacco is prohibited. The European Union legislation, however, does not address the issue of where vaping is permitted, leaving that to national and local jurisdictions.

Some Wall Street analysts predict that sales of the battery powered devices could surpass those of cigarettes within a decade. But the products and their use have quickly outrun any regulations on either side of the Atlantic. Some people hope this new technology will become a widely used alternative to tobacco. While their health effects are not fully understood, e cigarettes are generally considered less harmful than smoking.

E cigarette companies, supported by growing legions of e cigarette users, had lobbied hard against medicinal regulation. They welcomed the European Parliament vote as a victory for good health and good sense.

This is a fantastic result for public health and the millions of smokers around Europe who are switching to e cigarettes, said Charles Hamshaw Thomas, corporate affairs director of Britain s biggest e cigarette brand by sales volume, E Lites. Common sense has prevailed.

But while exempting e cigarettes from an onerous and potentially costly certification process required for drugs, an amendment to the Tobacco Products Directive approved by parliamentarians imposes tight restrictions on advertising and sponsorship. In these areas, e cigarettes face the same restraints as regular cigarettes, including the ban on sales to young people.

As expected, the European Parliament also voted to approve measures adopted this year by European Union officials, banning conventional cigarettes with menthol flavoring and requiring cigarette packs to carry health warnings in pictures and text covering 65 percent of the packages, up from 40 percent. But Parliament voted to delay the menthol ban by five years. It will take effect in eight years instead of three.

Regulators in the United States must now grapple with two serious concerns public health officials have raised about e cigarettes. Scientists are not certain of the health impact of using e cigarettes or of inhaling secondhand vapor. Perhaps more pressing, it is not clear whether e cigarettes will revive an interest in smoking by celebrating a behavior that health officials have spent decades trying to demonize.

These products threaten to undo all that, said Matthew L. Myers, president of Campaign for Tobacco Free Kids, who wants the F.D.A. to issue tough guidelines for how e cigarettes can be marketed and sold. With such regulations, e cigarettes have potentially positive value, he said, but we ve already seen that, if left to their own, e cigarette manufacturers will reach out to our children, do everything to maximize sales, including re glamorizing smoking, and that s where we are today.

E-cigarettes – european lung foundation[uk]

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Why are some healthcare professionals concerned about the use of e cigarettes?

E cigarettes have been the subject of intense debate in the media across Europe as some healthcare professionals are concerned about the promotion and use of the products.

The concerns include

Products are regulated differently E cigarettes are currently regulated differently across Europe. This means that there are no restrictions on the chemicals that can be added to the cartridges. This also means that they are not subject to strict quality control, and products may be labelled the same but have different amounts of chemicals and nicotine in them.

Continuing addictive behaviour As e cigarettes look and feel like a cigarette, users are not encouraged to change their behaviour. Their addiction to the physical and emotional elements of smoking continues.

Visibility for others who have quit There are no restrictions on e cigarettes being used in offices and other public places where normal smoking is banned. Smoke free legislation, which bans smoking in public places, has contributed to a change in the perception of smoking, de normalising it and making it seem abnormal and unacceptable. Some experts believe that visibility to people smoking e cigarettes could make smoking seem acceptable and could tempt people who have quit, or are trying to quit, to slip back into the habit.

Children s exposure to smoking Children who are growing up in areas where smoke free legislation has been common since their childhood are exposed to smoking behaviour when they see e cigarette users. Some experts feel this will undo the steps made by smoke free legislation in changing the perceptions of smoking. They are concerned that the behaviour of smoking, whether the product is an e cigarette or a tobacco cigarette, is once more being promoted to children and young people.

Lack of evidence A key concern for healthcare professionals at the moment is a lack of evidence on the potential harm to the user. Although the products are thought to be less harmful than smoking normal cigarettes, the devices contain various chemicals and long term studies on the health effects of the products have not yet been carried out. More research is needed on the harm caused by the mist, vapour, flavours and additives delivering nicotine.

The European Lung Foundation and the European Respiratory Society have responded to the uncertainty around the products and will conduct research to find out the short and long term effects of the products.