Last reviewed 18 June 2021

Following a request from the European Commission, the Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) has provided a Final Opinion on Electronic Cigarettes.

The Opinion focuses on the health impacts of using electronic cigarettes (e-cigarettes) compared to not smoking at all.

The Committee was asked to review the most recent scientific and technical information on e-cigarettes and to study the health effects of e-cigarette use (vaping), and their role in encouraging people to start or quit smoking.

The aim, the European Commission said, was to understand better the health effects and the public health dimension of e-cigarettes.

The Committee found the following, for users of e-cigarettes.

  • There is a moderate risk of irritation to the respiratory tract of e-cigarette users due to the cumulative exposure to polyols, aldehydes and nicotine. However, the overall reported incidence is low.

  • There is moderate evidence for risks of long-term systemic effects on the cardiovascular system.

  • The evidence is weak to moderate in terms of cancer of the respiratory tract due to long-term, cumulative exposure to the chemicals in e-cigarettes.

  • The weight of evidence for risks of adverse effects, specifically cancer, due to metals in aerosols is weak.

  • The overall weight of evidence for risks of other long-term adverse health effects, such as pulmonary disease, damage to the CNS and reprotoxic effects is weak, and further data is needed.

  • There is no specific data that particular flavourings used in the EU pose health risks for e-cigarette users following repeated exposure.

  • Finally, while the overall weight of evidence for risks of poisoning and injuries due to burns and explosion is strong, the incidence is low.

With regard to second-hand exposure, the Committee found the following.

  • The overall weight of evidence is moderate for risks of irritation to the respiratory tract, mainly due to exposure to glycols.

  • The overall weight of evidence for risks of systemic cardiovascular effects in second-hand exposed persons due to exposure to nicotine is weak to moderate.

SCHEER also came to the following conclusions.

  • There is moderate evidence that vaping is a gateway to smoking for young people. There is, however, strong evidence that nicotine in e-liquids is implicated in the development of addiction and that flavours have a relevant contribution for attractiveness of use of electronic cigarette and initiation.

  • The overall weight of evidence for carcinogenic risk due to cumulative exposure to nitrosamines is weak to moderate.

  • There is weak evidence for the support of electronic cigarettes' effectiveness in helping smokers to quit while the evidence on smoking reduction is assessed as weak to moderate.

The European Commission is currently revising the Tobacco Products Directive (2014/40/EU) and is assessing the potential need for legislative amendments under the Directive or for other regulatory/enforcement measures.