Despite tobacco consumption leading to 700,000 premature deaths across the EU every year, smoking levels among younger citizens remains stubbornly high, a new report has found.
A European Commission report on the effectiveness of the tobacco products directive, which limits advertising and other merchandising measures across the bloc since its introduction in 2016, found youth smoking rates fell to 20% in 2020 from 25% in 2014, after peaking at 29% in 2017.
Significant developments since the directive came into force have given new urgency and impetus to tobacco control work, the report said.
"The intermediate objective is to reach the WHO target of a 30% relative reduction in tobacco use by 2025 as compared to 2010, translating into an EU smoking prevalence rate of around 20% by 2025 compared to 29% in 2010."
To meet these ambitions, tobacco control efforts must be stepped up, including strengthening rules on tobacco products, it said.
The commission said the 2016 directive put in place comprehensive EU tobacco control policy rules, notably through enlarged combined health warnings, a track and trace system, a ban on characterising flavours, the creation of an ingredients database, and the regulation of electronic cigarettes.
It has also contributed to the improvement of public health through a decrease in tobacco consumption, it added.
However, the report found there is scope for improvement in labelling, assessment of ingredients, cross-border distance sales and novel and emerging products.
E-cigarettes, containing nicotine but no tobacco, are a specific diverse product category, accounting for up to 7% of the national EU markets, in terms of value, for tobacco and related products, the report said.
There are more than 300,000 active e-cigarette products, compared to over 42,000 active tobacco products, while big tobacco has tried to muscle in on the burgeoning market with major investments in electronic tobacco heating devices in recent years.
Safety concerns related to e-cigarettes spiralled worldwide in 2019, with vaping associated lung injury cases rising sharply in the USA, the report said.
However, these cases have since been linked to cannabis extract and/or vitamin E acetate containing e-liquids.
EU countries have not observed this trend, possibly due in part to the specificities of e-cigarette regulation, notably additive restrictions, such as a ban of vitamins in nicotine-containing liquids, the report said.
"There is strong evidence that flavours in e-liquids are attractive to youths and adults," the report warned.
Views on the actual health effects of e-cigarettes are divided, ranging from harmful to harm-reducing for the individual, compared to conventional tobacco products for smoking.
"As scientific consensus has yet to be reached, the precautionary principle prevails...The WHO further concluded that no firm evidence exists on the safety of e-cigarettes, but there is increasing evidence of harm," it said.