Electronic cigarettes and legal e-liquids – Overview

Introduction/Background

The electronic cigarette, also known as an e-cigarette, reproduces the feelings of a classic tobacco-based cigarette. The electronic cigarette is comprised of a battery, an atomiser and a cartridge filled with a liquid (e-liquid). This latter contains various aromatic substances (tobacco, menthol, apple, etc.), with propylene glycol and/or vegetable glycerine, additives, and depending on the vial, nicotine in different concentrations.

After inhalation, the liquid, mixed with air inhaled, is released as vapour, similar to the smoke of a traditional cigarette, and then inhaled by the user.

Production/Sale

Vape products are sold in specialised shops, tobacconists, or specialised on-line e-commerce sites. There are several generations of products, including open systems (with refill bottles, “e-liquids”) and closed systems (with disposable, non-refillable pods). The two types may or may not contain nicotine. 

The vape market has diversified over the last few years in terms of containers (technical tools which enable vaping, product design), contents (e-liquids offering a wider range of flavours), and marketing strategies (marketing, advertising). More recently, new forms have been brought out, such as disposable cigarettes and puffs (directly targeting young people) that have contributed to the even greater popularity of vaping.

The most recent data relating to the product shows that in 2020, 33 000 products were being marketed, with 70 000 distinct commercial references, 1 200 substances used as ingredients and generally between 2 and 16 ingredients per liquid.

The turnover for the sector has increased by 75% in three years, rising from €830 million in 2020 to €1.45 billion in 2023. This increase has been driven by the diversification of products offered and the rising rate of use by adults and adolescents. Tobacconists represent 15 to 20% of the distribution in the sector by value, as well as specialised shops numbering some 3 300, accounting for 50% of sales. Much of the rest of the market is carried out over the internet.

• Tobacco smoking and tobacco cessation in 2022. OFDT briefing paper, 2023, 16 p.

Use in the adolescent population

Among college and high school students

In 2022, one in five middle school students was already vaping and one ten had vaped in the past month. These two indicators have been stable since 2018. Daily use of the electronic cigarette was investigated for the first time in 2022, according to which 1.4% of middle school students showed a daily usage prevalence equivalent to that of tobacco cigarettes.

At high school, lifetime use of electronic cigarette involved 44% of high school students in 2022 (compared with 52.1% in 2018 and 35.1% in 2015). Recent use involved a quarter of high school students (24.2%), and 3.8% of high school students used them daily. These numbers have increased continually since 2018.

• Drug use in adolescence: trends reported in 2022. OFDT briefing paper, 2024, 17 p.

At 17 years old

According to the latest data available thanks to the Survey on Health and Drug Use on National Defence and Citizenship Day (ESCAPAD) of the OFDT carried out in 2022 concerning some 23 701 adolescents aged 17 years, 57% of the young people had experimented with the electronic cigarette and 6.2% vaped daily.

The percentage of daily vapers doubled between 2014 and 2022, accelerating since the start of the 2020s.

Furthermore, at the age of 17, daily vaping occurred twice as often in students attending general education than for apprentices (5.6% vs. 13.6%).

• Drug use in French 17-year-olds: analysis of the 2022 ESCAPAD survey. Tendances n°155, 2023, 8 p.

Use in the adult population

The most recent results from the Barometer survey of the French Public Health Agency Santé publique France showed that 41.2% of those aged 18-75 declared having tried an electronic cigarette. The prevalence of daily vaping has increased to 5.5%. This has not changed significantly compared with 2021, but an upward trend has been observed since 2016 (2.5% vaped daily in 2016).

Impacts

As no combustion occurs, electronic cigarettes do not generate the carcinogenic substances contained in cigarette smoke, or carbon monoxide or tar, but there is still a lack of research into the long-term effects of using them. It has been widely demonstrated that they are less dangerous than tobacco cigarettes.

With regard to the use of electronic cigarettes to help smokers give up smoking, although the scientific literature supports the potential benefits of vaping to help smokers quit, health professionals are not currently advised to recommend it, particularly because it is not a medical treatment.

Another point of debate concerns the role of electronic cigarettes as a gateway to smoking. There is scientific data to suggest that young non-smokers who vape may be at risk of taking up smoking, although research on this subject is still ongoing. Vaping in adolescence is associated with the risk of negative health outcomes, especially as far as the respiratory system is concerned.

Perceptions/Opinions

Young people’s perceptions of e-cigarettes are changing rapidly. The emergence of new formats, such as disposable cigarettes, contribute to the ever-greater popularity of vaping, while expensive and complex tools such as mods were seen as being reserved for adults. It seems that users are confused by the recent profusion of new tobacco and nicotine products (vaping with or without nicotine, heated tobacco, nicotine pouches etc.), without always knowing what they are consuming (nicotine content, risks, etc.).

Knowledge about health risks is more uncertain than for tobacco, whose harmful effects are now well known. On the other hand, the perception of health risks associated with vaping remain relatively blurred. This uncertainty is reinforced by suspicions relating to the composition of e-liquids.

• Perceptions, motives and trajectories associated with drug use in adolescents. Tendances n°122, 2017, 8 p.

Legal framework and recent public guidelines

Vaping products (i.e. the electronic cigarette itself, but also its components, refills, or liquids) are the object of a legal framework similar to those in force for tobacco smoking products, especially since the implementation of the European Directive 2014/40/UE on tobacco products. This directive mainly relates to health warnings.

Advertising or publicity (including sponsorships and patronage) and sales to minors are prohibited. Vaping is prohibited in schools or establishments intended for minors, enclosed public transport and covered public workplaces.