The European Union has struck a deal which could curb the booming market in electronic cigarettes and lead to an EU wide ban on a popular version of the nicotine device.

In hard fought negotiations between the 28 governments of the EU and the European parliament, both sides agreed on Tuesday that refillable e cigarettes could be banned across Europe if three countries decided on prohibition.

The parliament, under intense lobbying from the tobacco industry, took a more liberal line than the European commission, which proposed that e cigarettes be legislated for in the same way as pharmaceuticals. That was rejected in the compromise, but individual countries were left free to regulate e cigarettes as medicines.

Governments also took a more restrictive position on the issue and could still try to reverse some of the agreed elements. Ambassadors from the 28 countries will meet on Wednesday to decide whether to accept the compromise or return to negotiations.

The issue of e cigarettes quickly became the most contentious aspect of new EU rules on the packaging and sales of tobacco products, although the electronic devices contain no tobacco.

Public health warnings and graphic images of the damage done by smoking are to cover two thirds of cigarette packaging, and cigarette flavourings are to be proscribed, if gradually phased out.

Martin Callanan, leader of the Conservatives in the European parliament, said “This is a perverse decision that risks sending more people back to real, more harmful, cigarettes. Refillable e cigarettes would almost certainly be banned, and only the weakest products will be generally available. As many smokers begin on stronger e cigs and gradually reduce their dosage, making stronger e cigs harder to come across will encourage smokers to stay on tobacco.”

The key question centred on the impact of e cigarettes and whether they encouraged people to start smoking or whether they weaned nicotine addicts off tobacco.

“It’s inhaled. It’s direct inhalation of nicotine into the lungs. That creates an addiction very fast,” said a senior diplomat involved in the negotiations. “It encourages a switch to real cigarettes.”

The European e cigarettes market is currently estimated at 2bn ( 1.7bn), but it is growing fast, with approximately seven million users.

In the UK some 1.3 million of an estimated current 10 million smokers have switched to the electronic devices. Celebrity endorsements and social media are attracting young people to use e cigarettes in large numbers, according to a recent report commissioned by Cancer Research UK.

But public health experts are sharply divided about the devices some argue that they could substantially cut deaths from tobacco currently 100,000 annually in the UK while others warn they will only glamorise smoking, especially among the young.

One study of 657 smokers, published in the Lancet last month, found that e cigarettes worked as well as nicotine patches in helping people stop smoking within six months.

France, which has an estimated 1.5 million e cigarette users, is currently pondering a ban, but a mayor in Normandy has already introduced a local ban.

The EU agreement allows e cigarettes with a nicotine content below 20mg/ml to be regulated for general sale, rather than treating them as medicinal products. Governments had demanded a 3mg/ml limit.

The deal, however, lets individual governments regulate the cigarettes as medicinal products if they choose.

Refillable cartridges became the biggest sticking point, with the parliament threatening to veto the legislation if replacement sales were banned. On refillable e cigarettes, the compromise allows cartridges of 1ml of liquid containing up to 20mg of nicotine. But governments will be able to ban refillable e cigarettes and if three countries do so, then the commission is empowered to impose a blanket prohibition across the EU.

“This will lead to another ridiculous ban from the EU on the majority of e cigarettes which are better for the health of smokers and for British manufacturers of e cigarettes,” said Nigel Farage, the UK Independence party leader and MEP. “The EU should not be putting restrictions on a safer alternative to smoking.”

Carly Schlyter, a Green MEP and public health spokesman, said “Member states will be free to decide whether they want to subject them to authorisation as medicines or apply new rules that should ensure the quality and safety of these products. Either way should ensure that e cigarettes can be used safely to help smokers stop smoking, and not act as a gateway for non smokers.”

Rebecca Taylor, a Lib Dem MEP, said the possible ban on refillable cartridges could push consumers back to tobacco.

“This the exact opposite of what the tobacco directive is supposed to achieve. The fight is now on to show that it would not be justifiable to ban refillable cartridges on health and safety grounds.”

This article was amended on 19 December 2013 to change the word “will” to “could” in the subheading.

Quitnow – cigarettes and poison

Where can i buy duty free cigarettes online?
Cigarette smoke is a mixture of over 4000 chemicals, many of which are harmful to the human body.1 Currently all tobacco products available that are smoked deliver substantial amounts of toxic chemicals to their users and those who breathe their smoke.

Cigarette smoke is a combination of

  • mainstream smoke the smoke inhaled by a smoker
  • sidestream smoke the smoke from the end of a lit cigarette
  • second hand smoke the smoke exhaled by a smoker plus sidestream smoke.

Of the more than 4000 chemicals present in cigarette smoke, more than 60 have been identified as cancer causing chemicals, 11 of which are known to cause cancer in humans and 8 that have been associated with causing cancer in humans.1 Top of page

Cancer causing chemicals in tobacco smoke include

  • Benzene
  • 2 naphthylamine
  • 4 aminobiphenyl
  • Chromium
  • Cadmium
  • Vinyl chloride
  • Ethylene oxide
  • Arsenic
  • Beryllium
  • Nickel
  • Polonium 210.1,2

Toxic chemicals in tobacco smoke include

  • Nicotine the addictive agent in tobacco smoke
  • Formaldehyde used in preservation of laboratory specimens
  • Ammonia used in toilet cleaner
  • Hydrogen Cyanide used in rat poison
  • Acetone used in nail polish remover
  • Carbon monoxide found in car exhaust
  • Tar particulate matter in cigarette smoke
  • Toluene found in paint thinners
  • Phenol used in fertilisers.1,2

These chemicals are considered toxic because they have serious health impacts on the human body. For example

  • Hydrogen cyanide, carbon monoxide and tar cause, or are associated with, cardiovascular disease and chronic obstructive lung disease1
  • Ammonia and formaldehyde cause eye, nose and throat irritations and other breathing problems.4

The chemicals present in mainstream, sidestream and second hand smoke are similar however, the quantities of the various chemicals present differ. Sidestream smoke is generated at lower temperatures and under different conditions than mainstream smoke, and consequently it contains higher concentrations of many of the toxins found in mainstream smoke.5

With approximately one non smoker dying due to secondhand smoke exposure for every eight smokers dying of smoking related disease6 it is no surprise that second hand smoke has been designated a known human carcinogen (cancer causing agent).5 Further, about half of regular smokers will die of a smoking related disease and have a reduced life expectancy of about 13 to 16 years as compared with non smokers.7,8 Top of page

What’s in cigarette smoke?Tobacco smoke is a complex mixture of more than 4,000 chemicals in the form of gases, particles or both. When you inhale cigarette smoke, dozens of harmful substances enter your lungs and spread through your body. They can reach your brain, heart and other organs within 10 seconds of the first puff. The chemicals in cigarettes include the following

Nicotine an addictive drug and a toxin that narrows your veins and arteries. Nicotine raises your blood pressure and damages your heart by forcing it to pump faster and work harder. It slows your blood flow, reducing oxygen to your feet and hands. Some smokers end up having their limbs amputated.

Carbon Monoxide a gas that robs your heart of the oxygen it needs as fuel to pump blood around your body. Over time, your airways swell up and let less air into your lungs.

Tar is made up of many chemicals, including gases and substances that cause cancer. It coats your lungs like soot in a chimney. Changing to low tar cigarettes is not a healthier option as smokers usually take deeper puffs and hold the smoke in for longer, dragging the tar deeper into their lungs.

Phenols hazardous chemicals that paralyse and eventually kill the hair like cells that normally sweep clean the sensitive lining of your airways.

Fine Particles can irritate your throat and lungs, cause ‘smoker’s cough’, make you produce more mucus and damage lung tissue. Top of page

How else can smoking harm your health?Cancer smoking is widely recognised as causing lung cancer, but it also increases the risk of cancer of the lips, tongue, mouth, nose, oesophagus, pharynx, larynx, pancreas, bladder, cervix, vulva, penis and anus. There are also associations between smoking and cancers of the stomach, kidney, liver and blood.

Diabetes smoking worsens some of the health complications caused by type 1 diabetes, or insulin dependent diabetes. Evidence also shows that smoking is associated with an elevated risk of developing type 2 diabetes.9

Blood Circulation inhaling tobacco smoke can reduce the bloods ability to carry oxygen around your body and cause elevated blood fat levels (cholesterol and triglycerides). Blood clots are more likely to form in damaged arteries that can block blood flow to your heat, brain, or legs. Smoking is also the cause of dangerous plaque building up inside your arteries, causing them to narrow and creating blockages. this can lead to chest pain, weakness, heart attack or stroke.

Infections you will become more susceptible to bacteria and viruses because smoking damages the lining of your throat and lungs and weakens your immune system.

Breathing Problems in the long term, you are more likely to have some degree of emphysema, a disease that causes progressive shortness of breath, as smoking cuts the amount of oxygen able to be carried from the air into your blood.

Ageing smoking will cause premature aging, as wrinkles will appear around the eyes and mouth sooner and deeper than in non smokers. A woman who smokes tends to reach menopause one or two years earlier than a non smoker or an ex smoker because smoking reduces the amount of oestrogen in her body. She is also more likely to develop osteoporosis the weakening of the bones that accompanies ageing.

Hearing you may lose your hearing earlier than a non smoker, and are more susceptible to hearing loss due to ear infections and loud noise. This is due to decreased blood flow to the inner ear resulting from plaque build up on the blood vessel walls. Top of page

How does smoking affect parenting and babies?Smoking makes both men and women less fertile. Men who smoke produce less sperm, make more abnormal sperm and are much more likely to become impotent.

Women smokers often experience irregular or missed periods, along with unusual vaginal discharge and bleeding, which can affect fertility. Women who take the contraceptive pill and smoke are more likely to have a heart attack or stroke than non smokers.

A woman who smokes when pregnant can affect her unborn baby’s blood circulation, heart and other organs as the baby is exposed to nicotine, carbon monoxide and other toxic chemicals that are present in the mothers blood. Women that smok are more likely than non smokers to have a miscarriage, a stillbirth, a baby with a low birth weight or a baby that dies soon after birth or from cot death. A nursing mother who smokes passes some nicotine and other toxins to her baby through breast milk (although breastfeeding your baby is still better than bottle feeding, even if you smoke). Children of smoking parents may have impaired learning, slower growth and be shorter than children of parents who do not smoke. Top of page

What are the risks?Every year, about 15,000 Australians die from diseases caused by smoking. Half of these deaths will occur in middle age. Heart attacks and strokes are more frequent in smokers. In people under 65 years of age, smoking causes about 40 per cent of all strokes and heart disease. Smokers are four times as likely as non smokers to suffer sudden cardiac death and ten times more likely to die of bronchitis and emphysema. Smoking causes about 20 per cent of all cancer deaths and 80 per cent of lung cancers. Top of page

if I quit?Quitting smoking is the best thing most smokers can do to improve and protect their health and the sooner the better. The health benefits of quitting begin within a few hours and all nicotine and its by products are gone from your body within a few days. Many smokers notice improvements in their skin’s appearance. Sense of taste and smell within one week. Within three months the blow flow (notably to the hands and feet) will improve. Lings will start to recover enough to clear themselves of mucus. After just one year, the risk of heart disease will have almost halved. People who quit smoking can expect in the longer term to suffer fewer infections, lose fewer workdays to sickness, have a lower risk of strokes and cancers and live longer. Top of page

Where can I get help to quit?Giving up can be hard but is clearly worth it. If you want to quit, the Quitline can help. For the cost of a local call from anywhere in Australia, Quitline provides advice and assistance to smokers who want to kick the habit. It helps smokers plan their attempt, gives advice on different techniques, provides information on the availability of stop smoking programs and supplies written material on how to quit. Call
Quitline on 131 848. Top of page

  • Printable version of Tobacco Smoke is Toxic fact sheet (PDF 107 KB)

1) Hoffmann D, Hoffmann I and El Bayoumy K. The Less Harmful Cigarette A Controversial Issue. A tribute to Ernst L. Wynder. Chemical Research in Toxicology 2001, 14(7) 767 790.
2) The Department of Health and Human Services Tasmania. Fact Sheet Health Effects of Environmental Tobacco Smoke, 1/12/2006 (This link was valid at the time of submission.)
3) Tobacco smoke and involuntary smoking by IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, International Agency for Research on Cancer, Lyon, France World Health Organization International Agency for Research on Cancer, 2004. (This link was valid at the time of submission.)
4) Health Canada. Toxic Emissions Statement, 1/12/2006 #form (This link was valid at the time of submission)
5) U.S. Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke a report of the Surgeon General. U.S. Department of Health and Human Services, Centres for Disease Control and Prevention, National Centre for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006. (This link was valid at the time of submission)
6) Schick S and Glantz SA. Sidestream cigarette smoke toxicity increases with ageing and exposure duration. Tobacco Control 2006 15 424 429.
7) Peto R, Lopez AD, Boreham J and Thun M. Mortality from smoking in developed Countries, 1950 to 2000 Australia. (2nd edition, revised June 2006 ) (this link was available at the time of submission) available at Mortality from smoking in developed countries 1950 2005.
8) U.S. Department of Health and Human Services. The Health Consequences of Smoking what it means to you. U.S. Department of Health and Human Services, Centres for Disease Control and Prevention, National Centre for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, (This link was valid at the time of submission).
9) Tobacco in Australia website
10) Winstanley M,Woodward S and Walker N.,Tobacco in Australia Facts and Issues, 1995
11) The Quit website.
12) Curbing the Epidemic Governments and the Economics of Tobacco Control,The World Bank, 1999. (World Bank website)
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