Emerging electronic cigarette policies in European member states, Canada, and the United States. Issue 4 (April 2021)

• Record Type: Journal Article
• Authors: Snell, L. Morgan; Nicksic, Nicole; Panteli, Dimitra; Burke, Sara; Eissenberg, Thomas; Fattore, Giovanni; Gauci, Charmaine; Koprivnikar, Helena; Murauskiene, Liuba; Reinap, Marge; Barnes, Andrew J.
• Is Part Of: Health policy. Volume 125:Issue 4(2021)
• Page Start: 425
• Page End: 435
• Publication Date: 2021-04
• Subjects: BRFSS Behavioral Risk Factor Surveillance System (United States) -- CA FDA Canadian Food and Drugs Act -- CCCR Consumer Chemicals and Containers Regulations (Canada) -- CCPSA Canada Consumer Product Safety Act -- CDC Centers for Disease Control (United States) -- CTADS Canadian Tobacco Alcohol and Drugs Survey -- ECIG electronic cigarette -- EU European Union -- FCTC World Health Organization Framework Convention on Tobacco Control -- FDA United States Food and Drug Administration -- MLA minimum legal age of access -- POS point of sale -- TPD Tobacco Products Directive (European Union) -- TVPA Tobacco Vaping and Products Act (Canada) -- US United States -- WHO World Health Organization; Electronic cigarette -- E-cigarette -- Electronic nicotine delivery system -- Policy -- Regulation -- Tobacco -- Federalism; Medical education -- Periodicals; Medical policy -- Periodicals; Delivery of Health Care -- Periodicals; Education, Medical -- Periodicals; Health Education -- Periodicals; Health Planning -- Periodicals; Public Policy -- Periodicals; Enseignement médical -- Périodiques; Politique sanitaire -- Périodiques; Medical education; Medical policy; Periodicals; Electronic journals; Electronic journals; 362.1
• DOI: 10.1016/j.healthpol.2021.02.003
• Languages: English
• ISSNs: 0168-8510

Abstract

Highlights: Regulations to mitigate increasing electronic cigarette (ECIG) use vary significantly. ECIG use is common but varies across the EU, Canada, and US. Youth access laws and taxation are common policy strategies across regions. Significant variation is common regarding regulation of nicotine concentration, flavors, and packaging/advertising policies. Policy innovation offers rich opportunities to evaluate effective regulatory alternatives. Abstract: Background: Increased electronic cigarette (ECIG) use has motivated new regulations to address the changing landscape of tobacco use and promote public health. Method: This policy scan compares ECIG prevalence and regulations in the European Union (EU), Canada, and the United States (US) at the federal- and local-level to foster a policy dialogue around modern tobacco prevention and control regulations. Results: Among young adults, 40 % in the US, 29 % in Canada, and 28 % in the EU report ever using an ECIG. Results from the policy scan find significant variation in approach to regulating ECIGs. EU member states are subject to the most stringent requirements regarding nicotine concentration regulations, and several member states have also opted to ban flavors and/or require plain packaging or out of sight retail sales. Among EU and US states, taxation is a popular strategy, though taxing strategies vary widely. Regarding youth use, US states have led the way for increasing the legal age of sale to 21 at the federal level, and in Canada recent federal regulations are innovative in their approach to banning advertising that may appeal to youth. Conclusion: Strategies to achieve public health goals related to ECIGs vary widely, with federalism playing an important role in policy innovation, offering opportunities to evaluate their effectiveness and inform future regulations.