Bma — new safeguards for e-cigarettes backed by bma

The BMA has welcomed new controls around electronic cigarettes, after a compromise text for a revised EU tobacco directive was approved last week.

The revised directive aims to make tobacco products less attractive by strengthening rules on how tobacco products can be manufactured, presented and sold. In the Council of the European Union vote, 27 of 28 member states were in favour.

Safeguards on electronic cigarettes are to be introduced for the first time, with maximum levels agreed for nicotine concentration and the size of single use cartridges.

BMA director of professional activities Vivienne Nathanson said The BMA believes that proper regulation is essential to patient safety.

It is very pleasing that the EU is moving to put some controls in place in relation to electronic cigarettes.

How can doctors advise patients about the safe use of these devices if we do not know the contents for the user and those around them?

We must remember that nicotine is a poison, and access needs to be controlled.

Health risks evaluated

The European Commission will also report on the potential risk to public health from refillable electronic cigarettes, at the latest two years after the directive is implemented by member states.

If at least three member states have banned the refillable electronic cigarettes for justified reasons related to a serious risk to human health, the commission may extend the ban to all member states.

Today s agreement is a big step towards a healthier and more prosperous society, said the Lithuanian health minister Vytenis Povilas Andriukaitis.

It is also important for all stakeholders of the EU internal market, since it establishes clearer rules for manufacturers, retailers and consumers.

Other key measures to be adopted into national law by member states include a ban on fruit flavours and vanilla in tobacco, as well as one on menthol. This will come into effect four years after states adopt the directive.

Stringent packaging rules allowed

Combined picture and text health warnings must cover 65 per cent of the front and back of tobacco products and display a general warning, such as Smoking kills and the information message Tobacco smoke contains over 70 substances known to cause cancer.

The UK would be free to bring in plain packaging, as member states are to be allowed to introduce more stringent rules on additives or packaging of tobacco products.

In addition, tobacco products with misleading labelling, such as natural or organic , will also be banned.

The European Parliament and the Council of the European Union must now formally adopt the directive by vote, which should happen by March next year.

If it goes ahead, the measures could be adopted in the UK by June 2016.

The story so far

  • Tighter tobacco regulation moves a step closer
  • E cigarette regulation is good news
  • EU clinicans seek tougher tobacco laws

E-cigarettes may only be available in pharmacies

The sale of e cigarettes could be confined to pharmacies if three EU states impose restrictions, while refillable nicotine cartridges could be banned completely in Ireland, under plans from EU states.

Countries including Ireland staged a major pushback against the tobacco industry, which had won over many in the European Parliament to weaken new rules on smoking.

There was a danger that the first attempt to regulate the booming e cigarette industry, currently worth an estimated 2bn per annum, could fail as MEPs pushed for them to be freely available and contain much greater concentrations of nicotine than in single cigarettes.

But tough negotiations between the council, representing the member states, and the European Parliament overnight came up with a fresh set of compromises that would allow the EU to ban refillable cartridges if three states requested it.

Health Minister James Reilly is an ardent anti smoking campaigner and is leading the way in the EU by being the first country to produce legislation on plain packaging of cigarettes which would not contain the name of the brand.

He has been firmly against e cigarettes being sold across counters also, saying they were a gateway to smoking as they were targeting young people, rather than as a means to wean people off smoking.

The proposal now on the table in relation to the amount of liquid nicotine allowed in an e cigarette should be limited to 20mg/ml, similar to the dose of nicotine from a standard cigarette.

They must be sold in childproof containers with health warnings.

Maximum amounts of liquid nicotine for refillable containers are to be agreed. However, on the understanding that a given electronic cigarette or refill container that could pose an unforeseen risk to health, the European Commission would have the power to ban them if three EU states have already prohibited them.

The original proposal to consider e cigarettes as a medical device, like nicotine patches, and make them subject to rules for medicines and restrict their sale to pharmacies has been changed.

They will now be considered as a consumer item and may be sold over the counter in usual outlets, but some MEPs believe that in fact the outcome is unclear since they can be banned EU wide if three countries produce sufficient justification to ban them nationally.

The lead negotiator for the liberal ALDE group, Fr d rique Ries, said, Council and Commission were obsessed by the toxic and addictive qualities of nicotine, which remain in e cigs, and ignored their value in avoiding cancer, heart disease and respiratory problems connected with traditional cigarettes.

The provisions unfortunately now favour small dose and single use cartridges over refillable containers though the latter have been widely taken up by vapers .

Reaction varied from the European Parliament with British Tories saying it would take the majority of e cigarettes off the market and would restrict all but the weakest nicotine devices.

Member states representatives meet today to see if they all agree on the final draft with the e cigarette provisions remaining the main issue of contention.

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