However, in the United Kingdom there does not appear to be an outbreak of weapon-related illness. Vaping's popularity has also not risen among young people who have never smoked. Rather, e-cigarettes have been mostly embraced as a way for adults to quit combustible cigarettes. Indeed, the UK health authorities support their support for e-cigarettes as a stop tool.
"If you don't smoke, don't vape," said John Newton, director of health improvement at Public Health England. "But if you smoke, there are no situations where it would be better for your health to continue smoking instead of switching completely to vaping.
" PHE's advice remains that e-cigarettes are a fraction of the risk of smoking, and using one makes it much more likely that you will quit successfully than relying on willpower alone. "
What is different? Regulations, especially about advertising and marketing, and the levels of nicotine in vapor products.
" In the UK, the culture is that this is a substitute and not an initiation product, "said Bonnie Halpern-Felsher, professor of Pediatrics in Stanford Medicine's Division of Adolescent Medicine.
The Great Vape Debate
"There is a lot of public misconception about nicotine," the body said, with "less than 10% of adults understand that most health damage is caused by smoking. ng is not caused by nicotine. "
" Similar choices of flavors exist in the US and UK, and yet we do not have the same levels of youth as vaping here. Our much lower prices are due to our much stricter advertising regulations and possibly our lower nicotine cap, "a public health spokeswoman, England said Thursday.
Halpern-Felsher also noted these differences.
" In the United Kingdom, they primarily do not allow ads on the same way, and then you don't get advertising for young people, "said Halpern-Felsher. Outdoor advertising for example buses are allowed, but" e-cigarette companies just don't have a presence on social media and on TV or radio. "
In the United States, more than a quarter of high school students were current e-cigarette users in 2019, according to preliminary figures from the National Youth Tobacco Survey revealed last week.
The EU Tobacco Product Directive, which entered into force in 2016, lays down rules for the manufacture, presentation and sale of e-cigarettes in Member States. This includes restrictions on labeling, packaging and advertising. An EU report on the health and environmental risk of e-cigarettes is due by the end of 2020.
A 5% nicotine JuulPod contains "the amount of nicotine contained in two packs of cigarettes – one and a half to two packs," said Halpern-Felsher. "While the UK would not allow it."
That is not to say that there is no concern about the safety of e-cigarettes in the UK.
Public Health England said that vaping "is not entirely without risk" and emphasized that vapers should use "UK regulated e-liquids and never risk vaping homemade or illegal e-liquid or drug additions, any of which may be harmful. "
And the British Medicines and Health Products Regulatory Agency said 62 reports of side effects related to e-cigarettes had been reported by the public and health professionals between May 20, 2016 and September 6, 2019.
It is far from the United States, where illness and addiction have raised vaping to headlines.
The Trump administration's hold on banning e-cigarette flavors "will serve as a powerful tool that the FDA can use to combat the troubled trend of using e-cigarettes for youth. We must act quickly against flavored e-cigarette products that are particularly attractive to children, "said acting FDA Commissioner Dr. Ned Sharpless last week. "The tremendous progress we have made in reducing tobacco use for youth in the United States is at risk from this attack on e-cigarette use.
"No one wants to see children become addicted to nicotine, and we will continue to use the full scope of our supervisory authority thoughtfully and thoroughly to tackle this growing public health crisis. "
Some in the UK were critical of the Trump administration's plan.
"We know that prohibition does not work. Regulation works, "Marchant said." From the UK's perspective we have a very tightly regulated market … The diseases reported do not match the ingredients of professionally produced e-liquids. "
Professor Linda Bauld, professor of public health at the University of Edinburgh, said it would be a mistake for the United States to ban flavored e-cigarettes.
"It's true that a growing number of American teens have tried or recently used flavors that has caused alarm. But by removing all these products from the market, the proposed US policy forgets that flavors are an important part of the appeal to adult smokers who try to quit smoking, "she said.
" In Europe, flavored e-cigarettes have contributed to Recent declines in adult smoking and well-conducted randomized controlled trials show that these products are helping people quit. "
Views on arms around the world
It is estimated that around 35 million people around the world are believed to use e-cigarettes or newer heat-not-burn products, according to Euromonitor computer and research firm.
They are popular with smokers in many places who try to kick the habit as they satisfy the urge for nicotine while removing exposure to tar and toxins from burnt tobacco, but many worry that they will create new addictions of nicotine, especially among young people.
Nor has the organization thrown the weight behind the use of e-cigarettes as a way to quit.
"The scientific evidence of e-cigarettes discontinuing aids is crucial, and there is a lack of clarity as to whether these products have a role to play in smoking cessation," the global health agency said in a July report. "There are also real concerns the risks they pose to non-smokers who start using them, especially young people. "