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12 May 2021
PREVENT, - Tobacco & Smoking

The rapid introduction and increasing use of electronic cigarettes require urgent attention. Despite their popularity and commercialisation, there is a lack of consensus on e-cigarettes' general impact on health, both for smokers and passive smokers, and their connection to respiratory illnesses such as asthma and chronic obstructive pulmonary disease (COPD).

Now thanks to the work of the European Commission Scientific Committee on Health, Environmental and Emerging Risks (SCHEER), Europe has a science-based opinion on electronic cigarettes, one that clearly states that electronic cigarettes have harmful effects on human health.

This opinion comes at a crucial moment right before the Implementation Report of the Tobacco Products Directive that will be updated in May 2021. EFA contributed to public consultation to deliver the concerns of patients living with asthma and COPD.

EFA reacted to SCHEERs draft opinion on electronic cigarettes

In October 2020, EFA participated in a public consultation responding to the preliminary opinion of SCHEER on e-cigarettes. We welcomed the consultation as a timely response to mounting health concerns, yet noted a few criticisms stemming from patients with lung and respiratory health conditions.

Notably, EFA emphasised the need for parity in research between cardiovascular and respiratory diseases. The preliminary opinion focused on the former while side-lining the evidence linking e-cigarettes to asthma and COPD, particularly regarding long-term use and exposure.

EFA also insisted on the implementation of Article 8 of the WHO Framework Convention on Tobacco Control to guarantee 100% smoke-free environments. The potential risks of passive exposure and poor air quality have a disproportionate impact on people living with airways diseases.

Lastly, EFA urged SCHEER to consider the role of e-cigarettes in the initiation of smoking, especially among young people. EFA has long supported the regulation of e-cigarettes to be at the same level of conventional tobacco products, or higher, and urged SCHEER to launch or finance future studies exploring the link between health literacy and smoking initiation.

SCHEER integrated feedback for its final opinion on electronic cigarettes

In April 2021, SCHEER presented its final, revised opinion on e-cigarettes, which concludes that “there is moderate weight of evidence for risks of local irritative damage to the respiratory tract and moderate, but a growing level of evidence from human data suggesting that electronic cigarettes have harmful health effects, especially but not limited to the cardiovascular system”.

EFA was pleased to see an expanded focus on the impact of e-cigarettes on lung disease, especially on the development and exacerbation of asthma and COPD. Despite the need for more evidence on the overall impact of e-cigarettes, the final opinion acknowledges the robust evidence base documenting the effects of short-term impacts on lung health specifically. The final opinion also notes the need for more evidence on the long-term effects of use related to lung cancer.

Similarly, EFA welcomed the reiteration of the risk assessment scenarios for passive exposure to e-cigarettes. However, EFA continues to stress the importance of complete compliance to 100% smoke-free environments in Europe, as outlined in the WHO Framework Convention on Tobacco Control (FCTC).

EFA continues to advocate for SCHEER to launch or finance studies focusing on the links between health literacy and smoking in young people to guide targeted regulation of packing and marketing techniques. Therefore, EFA continues to support the regulation of e-cigarettes and other novel tobacco products to at least the level of traditional ones.


Continued assessment and regulation of e-cigarettes is critical to protect the health of smokers and passive smokers alike. As a patient organisation, EFA is committed to highlighting the unique harms that tobacco products produce for those with asthma, allergies and COPD. Moreover, EFA calls for mitigating the risks of disease development for all. EFA welcomes the final opinion from SCHEER on e-cigarettes and will continue to advocate for the advancement of research and regulation to protect the health of our patients, future patients and the public.

Read more about EFA response to SCHEER preliminary scientific opinion on e-cigarettes

Read more about our work on tobacco and smoking