The vape divide: 34 countries have banned e-cigarettes entirely as the WHO says they could be just as harmful as regular tobacco



By Luke Andrews Health Reporter For Dailymail.Com

17:40 20 Dec 2023, updated 18:20 20 Dec 2023



Once touted as a healthy way to quit smoking, vapes are now being banned in many countries amid fears they are ‘no better than cigarettes’.

A total of 34 countries — including Mexico, Brazil and Norway — had banned the sale of the devices by July 2023, according to the World Health Organization.

And 87 — mainly in the West — had imposed restrictions on their sales, such as outlawing certain flavors and online sales. Back in 2020, 79 had adopted bans.

The US — which has the largest vape market in the world — is nowhere near a nationwide ban, but there are signs of a shift among the states — with five outlawing the sale of flavored e-cigarettes.

The WHO — which recently called for all flavored vapes to be banned — is urging for more ‘urgent’ action to curb use of the devices. It noted that 74 countries don’t have any rules in place.

But even in areas where vapes are banned, the devices — and their fruity varieties — remain available because of poor enforcement.

The above map shows the countries that have banned the sale of e-cigarettes or imposed restrictions. It comes amid an international tug-of-war over the devices

About one in twenty adults — or 11million people — use vapes in the United States, according to statistics.

But among teenagers and young adults, use is as high as one in four in certain age groups.

Tobacco companies claim e-cigarettes are safer than traditional cigarettes and pose significantly lower risks to health.

But a growing body of evidence shows the devices generate dangerous substances that damage the lungs and raise the risk of heart and lung problems.

WHO Director-general Tedros Adhanom Ghebreyesus said earlier this week: ‘Kids are being recruited and trapped at an early age to use e-cigarettes and may get hooked on nicotine.’

‘I urge countries to implement strict measures to prevent uptake to protect their citizens, especially their children and young people.’

The WHO’s director of health promotion, Dr Ruediger Krech, added: ‘E-cigarettes target children through social media and influencers, with at least 16,000 flavors.

‘Some of these products [even] use cartoon characters and have sleek designs, which appeal to the younger generation.’

Highly potent e-cigarettes are extremely addictive. Of all the young people who had tried one, nearly half became regular users.
Oklahoma topped the list for the highest number of vape users in a survey published last month

Countries are scrambling for the best way to regulate vapes amid their surging popularity and growing concerns over their health effects.

Many are imposing bans or restrictions, but a lack of enforcement is making largely ineffective in some areas — with vapes remaining available. 

Over the last three years, six countries have moved to ban the sale of vapes entirely — Cabo Verde, Laos, Nicaragua, Norway, Turkey and Vanuata.

Turkey has banned the import of e-cigarettes as well as their sale and distribution, with its ruler Recep Tayyip Erdogan previously saying of vape companies: ‘They get rich by poisoning our people, we will not allow that.’

In Norway, the country has a ban on all new nicotine products entering the market but it is already looking to loosen the restriction.

Its health ministry says vapes should be made available to help people quit smoking, but plans to refuse to sell the fruit and berry flavors people get hooked on.

The above shows the status of e-cigarettes, or Electronic Nicotine Device Systems (ENDS), across high, middle and low income countries
The above gives estimates for the growth of the e-cigarette market globally. The US is included in the grey line for ‘western European and other countries’
The above shows the proportion of students in 12th, 10th and 8th grades who used vapes containing nicotine annually since 2019

Over the same period, four countries have gone the other way and lifted their restrictions on vapes — Egypt, Kuwait, Bahrain and the Palestinian territories.

For Egypt, where about one in five adults smoke and the biggest smoker in the Middle East, the ban was lifted in 2022 to make vapes available to help people quit cigarettes.

HALF of American school students who try e-cigarettes become addicted 

Half of children who try vaping become addicted, according to a major CDC analysis that shows millions of school students are using e-cigarettes. 

In the US, policymakers are coming under pressure to do more to regulate the sale of e-cigarettes in the country and their availability to children.

All e-cigarette companies are meant to apply to the Food and Drug Administration (FDA) for approval before selling their products in the US.

But enforcement of this rule has been patchy at best, with flavored vapes widely available despite the FDA having never approved a flavored device. The agency says it will not authorize flavored vapes without ‘extraordinary evidence’.

Five states in the US have banned the sale of flavored vapes —  California, Massachusetts, New Jersey, New York and Rhode Island — alongside several cities.

The strictest ban is in place in San Francisco, which banned the sale of all vape devices in 2019 in an attempt to crack down on their use in the city.

Another eight states — Arkansas, Georgia, Hawaii, Maine, Oregon, South Dakota, Utah and Vermont — ban online sales of e-cigarettes.

But many experts say more action is needed to discourage youngsters from picking up the habit and becoming hooked on nicotine.

Current statistics show nearly eight percent of middle and high school students vape, or around 2.1million children, mostly using flavored devices.

A quarter of children in 12th grade admit to using the devices at least once within the past year. 

This figure has dropped slightly, from 2.55million in 2022, which the Centers for Disease Control and Prevention (CDC) heralded as ‘great progress’ — but experts say much more work is needed.

The maximum level of nicotine permitted in a vape is fixed at 20 milligrams of nicotine per milliliter of liquid (two percent) in Europe, the UK, and Canada. These devices last for around 550 to 600 puffs. In the US, it’s fairly easy to find a device or pod containing as much as 5 percent nicotine

EVERYTHING YOU NEED TO KNOW ABOUT VAPING 

What are e-cigarettes?

E-cigarettes are devices that allow you to inhale nicotine in a vapor rather than smoke.

They do not burn tobacco or produce tar or carbon monoxide — two of the most harmful parts of tobacco smoke.

The devices work by heating liquid that contains nicotine and flavorings.

They can come as vape pens — which are shaped like a pen or small tube with a tank to store e-liquid and batteries — or pod systems that are rechargeable and often shaped like USB sticks.

Are they dangerous?

E-cigarettes are not risk-free but are believed to cause less harm than smoking.

However, its liquid and vapor contain harmful chemicals that are also found in traditional cigarettes, but it much lower levels. 

These chemicals have been linked to lung inflammation, chronic coughs, shortness of breath and lung disease.

Some chronic users have developed obstructions in their lung pathways that cause them to suffer ‘asthma-like’ symptoms. 

There have also been cases of e-cigarettes exploding or catching fire.

Can children buy them?

Like cigarettes, an American must be at least 21 years old to purchase a vape.

Many physical retail locations neglect to check identification for customers, allowing children to access the devices.

Around 75 percent of Juuls in the hands of minors in the US came from physical locations, a 2018 report found. 

Many also get the device from a friend or family member.

What has the FDA done to curb vape use?

The FDA has banned the sale of flavored nicotine products in the US unless a company has received their approval.

All products sold by e-cigarette giant Juul were ordered to be pulled from the market last June under these new rules

It found that there was not enough evidence to confirm its products did not harm public health.

In November, the FDA issued a warning to online retailers to stop marketing e-cigarettes to kids to ‘quickly protect public health’

Other popular brands, like Puff Bar, have received warnings from regulators about the sale of flavored devices as well. 



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