Urgent action is needed to control e-cigarettes to protect children, as well as non-smokers and minimize health harms to the population. E-cigarettes as consumer products are not shown to be effective for quitting tobacco use at the population level. Instead, alarming evidence has emerged on adverse population health effects.
E-cigarettes have been allowed on the open market and aggressively marketed to young people. Thirty-four countries ban the sale of e-cigarettes, 88 countries have no minimum age at which e-cigarettes can be bought and 74 countries have no regulations in place for these harmful products.
Children 13–15-years old are using e-cigarettes at rates higher than adults in all WHO regions. In Canada, the rates of e-cigarette use among 16–19-year-olds has doubled between 2017–2022, and in England (the United Kingdom) the number of young users has tripled in the past three years.
Even brief exposure to e-cigarette content on social media can be associated with increased intention to use these products, as well as more positive attitudes toward e-cigarettes. Studies consistently show that young people that use e-cigarettes are almost three times more likely to use cigarettes later in life.
Urgent measures are necessary to prevent uptake of e-cigarettes and counter nicotine addiction alongside a comprehensive approach to tobacco control, and in light of national circumstances.
- Where countries ban the sale of e-cigarettes, to strengthen implementation of the ban and continue monitoring and surveillance to support public health interventions and ensure strong enforcement; and
- Where countries permit commercialization (sale, importation, distribution and manufacture) of e-cigarettes as consumer products, to ensure strong regulations to reduce their appeal and their harm to the population, including banning all flavors, limiting the concentration and quality of nicotine, and taxing them.
Cessation strategies should be based on the best available evidence of efficacy, to go with other tobacco control measures and subject to monitoring and evaluation. Based on the current evidence, it is not recommended that governments permit sale of e-cigarettes as consumer products in pursuit of a cessation objective.