E-cigarette Regulations and Why They Fail

This chapter explores contemporary e-cigarette regulation. It begins with a historical overview of the recent developments in e-cigarette regulation, with a particular focus on the U.S. market. Next, the different ways in which e-cigarettes have been classified by national regulators (as consumer products, tobacco products, medicinal devices, or poisons) is explored. The relationship between classification and policy decisions is also discussed. The rationale for and examples of various e-cigarette policies, including taxation, flavor restrictions, nicotine content limits, marketing and advertising bans, age limits, and public-use bans are then explored. Whether and to what extent each of those policies has achieved the intended goal of reducing e-cigarette use is examined. The discussion then explores the growing evidence suggesting that several policies designed to reduce demand for e-cigarettes have inadvertently increased smoking. Other unintended consequences are also discussed, including the use of “DIY” products, after-market modifications, and illicit trade. The chapter closes with discussion of the factors contributing to sub-optimal e-cigarette policies: misinformation, the power of rhetorical appeals to emotion, short-termism, a reluctance to course-correct, policy sharing, insufficient understanding of the options, reputational risks, and a lack of high-profile “champions” promoting harm reduction.