Telefon: (+48) 22 369 29 00 ul. Wawelska 52/54, 00-922 Warszawa
info@klimat.gov.pl Ministerstwo Klimatu i Środowiska
www.gov.pl/klimat
Działamy zgodnie z EMAS - zarządzając instytucją, dbamy o środowisko
Podsekretarz Stanu
Anita Sowińska
DGO-OP.050.2.2024.MD
3041979.11849173.9558312
Warszawa, 23-02-2024
Pan
Szymon Hołownia
Marszałek Sejmu RP
W odpowiedzi na interpelację Pana Posła Aleksandra Miszalskiego z dnia 13 lutego 2024 r.
w sprawie jednorazowych e-papierosów smakowych (znak: K10INT1390), przekazuję
poniższe informacje.
4) Czy Ministerstwo Klimatu i Środowiska dysponuje badaniami dotyczącymi wpływu
korzystania z jednorazowych e-papierosów na środowisko, w szczególności
w związku z faktem, iż tego rodzaju urządzenia są wyposażone w jednorazowe baterie
oraz wynikające z funkcji tych urządzeń zjawisko generowania tzw. elektro-śmieci?
Ministerstwo Klimatu i Środowiska nie dysponuje badaniami dotyczącymi wpływu
korzystania z jednorazowych e-papierosów na środowisko.
Użytkownik, chcąc pozbyć się zużytego sprzętu elektrycznego lub elektronicznego, jest
zobowiązany do oddania go do punktu zbierania zużytego sprzętu. Zgodnie z art. 37 ustawy
z dnia 11 września 2015 r. o zużytym sprzęcie elektrycznym i elektronicznym (Dz. U. z 2022 r.
poz. 1622, z późn. zm.) każdy sklep ze sprzętem ma obowiązek przyjmować zużyty sprzęt bez
pobierania opłat, o ile zużyty sprzęt jest tego samego rodzaju i pełnił te same funkcje co
sprzęt sprzedawany. Z kolei dystrybutorzy prowadzący jednostkę handlu detalicznego
o powierzchni sprzedaży wynoszącej co najmniej 400 m2 poświęconej sprzedaży sprzętu
przeznaczonego dla gospodarstw domowych, są obowiązani do nieodpłatnego przyjęcia
w tej jednostce lub w jej bezpośredniej bliskości zużytego sprzętu pochodzącego
z gospodarstw domowych, którego żaden z zewnętrznych wymiarów nie przekracza 25 cm,
bez konieczności zakupu nowego sprzętu przeznaczonego dla gospodarstw domowych.
Zwrotu zużytego sprzętu można dokonać także w punktach selektywnego zbierania
odpadów komunalnych.
Z wyrazami szacunku
Anita Sowińska
Podsekretarz Stanu
Ministerstwo Klimatu i Środowiska
/ – podpisany cyfrowo/
Do wiadomości:
Departament Spraw Parlamentarnych w KPRM.

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telefon: +48 22 250 01 46 ul. Miodowa 15
adres email: kancelaria@mz.gov.pl 00-952 Warszawa
www.gov.pl/zdrowie
ZPP.050.16.2024.JS
Warszawa, 26 lutego 2024
Pan
Szymon Hołownia
Marszałek Sejmu RP
Szanowny Panie Marszałku,
odpowiadając na interpelację poselską Pana Aleksandra Miszalskiego, przesłaną w dniu
13 lutego 2024 r., nr 1390, w sprawie jednorazowych e-papierosów smakowych,
uprzejmie proszę o przyjęcie poniższych informacji.
Odpowiadając na pytanie pierwsze uprzejmie informuję, że przykładem najnowszych badań
dotyczących kwestii szkodliwości używania jednorazowych elektronicznych papierosów
jest raport Światowej Organizacji Zdrowia (WHO) przygotowany na dziesiątą Konferencje
Państw-Stron Ramowej Konwencji Światowej Organizacji Zdrowia o Ograniczaniu Użycia
Tytoniu (FCTC), która miała miejsce w dniach 5-10 lutego br. w Panamie
(dokument w załączeniu).
Przedmiotowy raport wskazuje m.in., że płyny w jednorazowych elektronicznych
papierosach, podgrzewane w wysokich temperaturach, tworzą nowe i słabo poznane
związki chemiczne, a dodatek środków aromatyzujących w znaczący sposób może
zwiększać toksyczność wydzielanego aerozolu. Warto także zaznaczyć, że przedmiotowe
produkty pozwalają na wysokie spożycie nikotyny w bardzo krótkim czasie. Istnieją dowody
naukowe wskazujące, że nikotyna jest silnie uzależniającą substancją, której używanie
– w szczególności przez dzieci i młodzież – może prowadzić do wielu negatywnych
konsekwencji zdrowotnych.
W omawianym raporcie WHO zwraca uwagę również na kwestię ochrony środowiska
naturalnego, gdyż komponenty jednorazowego elektronicznego papierosa, w szczególności

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telefon: +48 22 250 01 46 ul. Miodowa 15
adres email: kancelaria@mz.gov.pl 00-952 Warszawa
www.gov.pl/zdrowie
2
obudowa, akumulator litowo-jonowy i toksyczne pozostałości chemiczne, są wyrzucane
po jednorazowym użyciu, stwarzając tym samym poważne zagrożenie środowiskowe.
WHO wskazuje również, że istnieją mocne dowody na to, że używanie elektronicznych
papierosów zwiększa szanse palenia tradycyjnych papierosów o około trzykrotnie
(szczególnie wśród młodzieży) oraz, że długoterminowe skutki zdrowotne używania tych
produktów są nieznane, podobnie jak skutki zdrowotne podwójnego zastosowania
z paleniem papierosów. Jednak niektóre badania sugerują, że podwójne zastosowanie jest
co najmniej, a może nawet bardziej, szkodliwe niż wyłączne palenie tradycyjnych
papierosów.
Odnosząc się do pytania drugiego uprzejmie informuję, że w przypadku młodzieży w wieku
13-15 lat w Polsce w 2022 r. elektroniczne papierosy były używane przez około 23,4%
dziewcząt i 21,2% chłopców. Częstość użycia elektronicznych papierosów wśród polskich
nastolatków stawiają pod tym względem polską młodzież w czołówce krajów
Unii Europejskiej.
Nawiązując do pytania trzeciego należy zaznaczyć, że istotnym jest podjęcie niezwłocznych
działań ograniczających dostęp tego rodzaju produktów, w szczególności dla młodzieży.
Obecnie Ministerstwo Zdrowia analizuje możliwości realizacji szybkich i skutecznych
rozwiązań legislacyjnych w omawianym temacie. W ocenie Ministerstwa Zdrowia działania
związane z ograniczaniem dostępu do elektronicznych papierosów, w szczególności wśród
osób młodych, wpisują się w kierunek działań ochrony zdrowia publicznego przed
następstwami chorób odtytoniowych.
Z wyrazami szacunku
z upoważnienia Ministra Zdrowia
Wojciech Konieczny
Sekretarz Stanu
/dokument podpisany elektronicznie/

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Background Paper: Disposable electronic cigaretes (D-ENDS) in selected
countries and their characteris�cs. A short overview of the available
evidence.
Introduc�on to disposable ENDS
Electronic nico�ne delivery systems (ENDS), commonly known as e-cigaretes, were ini�ally created
in 2003 in China, but they really started to circulate on the global market from around 2008-2009.
They exist in different forms, with older genera�ons called “cig-a-like” imita�ng conven�onal
cigaretes in appearance. More recent types of ENDS are open systems (third genera�on ENDS, or
MODs — open/modifiable devices — that is, bulky ENDS where the consumer can mix their own e-
liquid) or the cartridge systems (fourth genera�on, PODS, like the brand Juul, or new brands like
VEEV by Philip Morris Interna�onal, or PMI).1 ENDS can also be produced without nico�ne, in which
case they are referred to as Electronic non-nico�ne device systems or ENNDS.
Since 2018-2019, a new (or fi�h) genera�on of ENDS has appeared on global markets: the
disposable e-cigarete (D-ENDS). Normally, D-ENDS are composite products discarded a�er the e-
liquid content is consumed, which means that all device components (plas�c, metal, lithium
batery, toxic chemicals, etc.) are simply thrown away. This, combined with the health risks of those
products, raises a major environmental issue. Some brands of D-ENDS also commercialize non-
nico�ne products or D-ENNDS. Even if free from nico�ne, D-ENNDS are composite products raising
the same issues as D-ENDS. Throughout this document, we will refer generally to D-ENDS.
The first major brand of D-ENDS to appear was the Puff Bar, which is some�mes used as a general
name for those products. They flooded the US market in 2019, rapidly displacing the Juul, especially
among youth. In Europe, D-ENDS seem to have appeared in late 2019-early 2020. Ini�ally, also
because of the Covid-19 crisis and lockdown, many health professionals did not no�ce its arrival
and health authori�es have been very slow to respond.2
Most, if not all, D-ENDS are produced in China, and the main produc�on loca�on is the city of
Shenzhen. The market is very opaque, with a few major companies domina�ng the market (but
some�mes the same company has different names and iden��es, which makes a mapping of the
market very difficult). However, some big tobacco companies are trying to catch up and are
introducing their own D-ENDS brands, like Vuse by Bri�sh American Tobacco (BAT).
Characteris�cs of disposable e-cigaretes
Technologically speaking, a D-ENDS is a very simple product composed of a casing (metal or plas�c),
a batery of variable strength, a hea�ng element, a small container with a coton ball (some�me
replaced by a form of plas�c) imbibed with the e-liquid. To “puff” is very simple: there are no
1 For general information about ENDS, please check this page: https://www.at-schweiz.ch/en/knowledge/products/ends
2 For general information and a factsheet on disposable ENDS please refer to this page: https://www.at-
schweiz.ch/en/knowledge/products/puffbar

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butons to press, one just need to bring the device to the lips and take a drag, the device then heats
the e-liquid automa�cally.
Fig. 1: usually a disposable ENDS is composed by 1- airflow activator, 2- battery, 3- casing, 4-
plastic tube containing cotton imbibed with e-liquid.
The three main parts of the device are:
The batery: bateries range from 280mAh to 850mAh. Even if most devices contain rechargeable
lithium-ion bateries, the products are designed to be discarded once the liquid runs out.
The coil: this is a metal element that is heated. Usually, it is inserted right into the core of the
imbibed coton to heat it up. Given the huge number of different products, it is difficult to know
exactly which metals the coil is made of. There is a risk that this metal coil will release heavy metals
in the hea�ng process. During the use of a D-ENDS, when the liquid diminishes, the coil will tend to
heat at an increased temperature, which can easily rise above combus�on level.
The pod: the plas�c pod contains a piece of coton imbibed with the fluid. The coton and part of
the liquid are organic materials; they therefore degrade over �me and many products have a �me-
limited consump�on date and are unstable. Usually, the size and capacity of the pod ranges from
300 up to 15 000 puffs, or number of inhala�ons. It is usually considered that an Elf bar 800 gives a
nico�ne equivalent of 60 cigaretes, therefore a 15 000 D-ENDS would then correspond to 1,125
and can be found on an US website for the price of US$19.99. (1)
The e-liquid: The composi�on of the fluid (commonly referred as e-liquid) is not always clearly
defined and shows a large varia�on within brands and manufacturers. (2) More than 80 compounds
have been detected in liquids and aerosols. ENDS almost always contain nico�ne, and the addi�on
of flavourings increases the toxicity of ENDS aerosol in a significant manner. There is also a large
and increasing number of flavourings. (3) It be noted that in 2022, China banned the inland sale of
ENDS flavours other than that of tobacco, but not their export abroad. (4) The heat generated by
ENDS leads to the oxida�on and decomposi�on of its components, eventually forming harmful
cons�tuents in the inhaled vapor. Therefore, the toxicity of fluids and aerosols should be measured
separately.

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D-ENDS Availability and regula�on
About 47 countries have banned ENDS in general. (5) However, regula�ons are very different, and
a ban can cover some aspects but not others (sale, import, possession) which makes clear mapping
difficult. In addi�on, in countries with exis�ng bans, there some�mes exist tolerated “illicit”
markets.
Of the other countries where ENDS are not banned, only one currently seems to have specifically
banned disposable ENDS: the French overseas territory of New Caledonia. Some European
countries are discussing a possible ban of D-ENDS (at government or parliamentary level), but no
country has taken ac�on yet (those countries include Ireland, France, Germany, the Sco�sh
devolved government and the rest of the UK).
Table 1: ENDS bans per WHO regions (indica�ve)
ENDS are formally banned* in: Comment
African Region
(AFR)
Gambia, Mauri�us, Uganda Only a handful of countries have
adopted a ban, D-ENDS are appearing in
increasing numbers of countries too.
Region of the
Americas
(AMR)
Argen�na, Brazil, Chile,
Colombia, Mexico, Panama,
Suriname, Uruguay, Venezuela
In Brazil and Mexico, D-ENDS appear to
circulate freely, and web shops are
commonplace. (6)
South-East
Asian Region
(SEAR)
Brunei Darussalam, Cambodia,
DPR of Korea, India, Malaysia,
Singapore, Sri Lanka, Thailand,
Timor-Leste
In some countries the ban is clearly
enforced, in others like Thailand we note
a presence of sale through social media
channels (Facebook (FB), Tiktok).
European
Region (EUR)
Only Turkmenistan appears to
have adopted a ban.
Most countries allow ENDS and D-ENDS,
and products are cheap and readily
available. In the European Union (EU), it
appears that there is litle effec�ve
control on D-ENDS’ chemical contents.
Eastern
Mediterranean
Region (EMR)
Bahrain, Egypt, Ethiopia, Iran
(Islamic Republic of), Iraq,
Jordan, Kuwait, Lebanon, the
West Bank and Gaza Strip,
Oman, Qatar, Syrian Arab
Republic
Ban enforcement appears to differ
among countries. In at least some,
however, D-ENDS are freely distributed
(ex. Lebanon). (7)
Western
Pacific Region
(WPR)
French overseas territory of
New Caledonia appears to be
the only territory to have
specifically banned D-ENDS
Australia has strongly regulated ENDS,
which can be sold only in pharmacies
(since October 2021), however this ban
has not been effec�ve given steep of D-
ENDS consump�on among youth. (8)
*This list is not complete. There is no central full updated repository of laws regulating ENDS.
Some resources are helpful: https://www.tobaccocontrollaws.org/

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According to its own manufacturer declara�on, Elf bar is a major global brand of D-ENDS, present
in at least 80 countries. (9)
For countries where ENDS have not been totally banned, regula�on is o�en poor. D-ENDS appeared
on the market in 2018-2019 but did not atract much aten�on at first. They really started to be
sold more systema�cally in Europe only in 2020. At the �me, more aten�on was given to products
like Juul (pods ENDS), but D-ENDS rapidly displaced Juul, and it disappeared from European markets
in December 2021. The arrival of D-ENDS was also overlooked because they appeared on most
markets during the Covid-19 lockdown restric�ons.
In addi�on, we also observe a strong industry lobbing ac�vity to regulate newer products (heated
tobacco products, or HTPs, snus and nico�ne pouches, and ENDS in all its forms) as litle as possible,
o�en insis�ng on rhetoric pretending that they are a “safer” alterna�ve to tobacco products (as
long term impacts are not known, nobody can today scien�fically evaluate how much, if at all, those
products are less risky than tobacco products).
Generally, D-ENDS are allowed in many markets without any effec�ve form of control. Only limited
regula�on exists in many jurisdic�ons. Nico�ne content is regulated in the EU (plus the UK,
Switzerland, and others) with a maximum limit of 20 mg/ml (or 2%). This is already considered a
strong concentra�on. In many other countries (US, South-East Asia), it is easy to find products with
50 or 60 mg/ml. The volume in closed ENDS-like D-ENDS is also limited to a maximum of 2 ml, as in
the EU, which generally allows up to 600 to 800 puffs, However, it is common to find D-ENDS with
contents exceeding 2 ml in many EU countries.
Taxa�on o�en lags behind. Generally, we observe that ENDS and D-ENDS are extremely cheap in
comparison to tobacco products, and in many countries, they are not taxed or only lightly. In
considering taxa�on, we should also consider the profit margins on these products: from
produc�on to sale, profits can easily exceed 1000% of the produc�on and distribu�on costs. Prices
drive the markets: in the UK, a recent increase of taxa�on has brought the price of cigaretes to
more than £15 (US$19.30), while one can easily find D-ENDS for prices star�ng at £4. With the
recent economic crisis, how is this price gap affec�ng consumers?
D-ENDS distribu�on networks are also expanding very rapidly. In Bangladesh, data published on 4
April 2023, showed that nearly 78% of e-cigarete outlets opened in the five years from 2017—
2021: while once ENDS shops were found mostly in wealthier areas of Dhaka, they are now open
across the country. (10)
Market informa�on
According to some market reports, the global market value in 2022 was of US$ 6.8 billion, with a
forecast to reach US$ 14.8 billion by 2030.(11) However, market and financial data collec�on is very
difficult for this market, and we consider available data as being gross underes�ma�ons. Two
elements support our view on this point.
• A Chinese wholesale web page offered over 230 000 different products in November 2021;
in March 2023, the number of different disposable ENDS on this website was around

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550 000.(12) The Made-in-China web page is in English only and appears to be focused only
on goods for exported out of China.
• In the UK, in February 2023, one single product of one brand (the Elf Bar 600) was selling
2.5 million units per month at £5.99 per unit, which if mul�plied by 52 weeks, works out as
over £778.7 million, annually.
Currently, major markets appear to be rich countries like the US and Europe, but the situa�on is
evolving very fast, and D-ENDS are already available in many countries, including countries where
ENDS are supposedly banned. According to a market report, in the Middle East and Africa, the
market for D-ENDS is expected to witness a compound annual growth rate (CAGR) of 12.7% up to
2030. (11) This is probably, again, an underes�ma�on. In Switzerland it is es�mated that the D-
ENDS market increased by 2200% in 2022, based on distributor data. (13)
We should also consider the amount of investment made in this market. Although informa�on is
vague, a single example can be telling. Geekvape built its own Zhuhai industrial park in 2022, which
has an area of over 200 000 square meters for a total investment of US$1.55 billion. Geek will
produce in this new Zhuhai facility various kinds of ENDS (open systems, as well as D-ENDS). (14)
Prevalence of D-ENDS
Prevalence data is only star�ng to emerge. Surveillance systems have been slow to adapt to the
very rapid changes in product development and market availability. Further, in many surveys
various ENDS genera�ons are s�ll not differen�ated, as they should be.
Some recent surveys are summarized below. We should stress that in all of them D-ENDS
prevalence was significantly on the rise and for most other products (HTPs, snus, nico�ne pouches)
prevalence had increased, and that no significant decrease was observed in cigaretes prevalence.
Table 2: Most recent D-ENDS prevalence surveys in young people.
Year of
the
survey
Country Main results
2022 Australia
(15)
Among 15- to 30-year-olds, current ENDS users were 14% or having
used e-cigaretes in the past (33%). D-ENDS were most popular, used
by 60% of ENDS users and with especially high rates among younger
users (80% of 15- to 21-year-olds compared with 49% of 22- to 30-
year-olds).
2022 France (16) Among 13–16-year-olds, 13% have already tried D-ENDS and 9%
have already bought them.
2022 Sweden
(17)
Among 15–16-year-olds regular D-ENDS consump�on was 20% and
among 17-18 this was up to 40%.
2022 Switzerland
(18)
Among 14-17 years olds regular D-ENDS consump�on was 9% and
among 18-25 years old it was 13%.

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Year of
the
survey
Country Main results
2022 Switzerland
(19)
In the last Swiss round of WHO’s Health Behaviour in School-aged
Children (HSBC), among 14–15-year-olds regular consump�on of
ENDS was 21%.
2022 USA (20) In 2022, 14.1% of high school students and 3.3% of middle school
students reported current ENDS use. Among current ENDS users,
42.3% reported using ENDS frequently, including 46.0% of high
school students and 20.8% of middle school students; daily use was
reported among 27.6% of current ENDS users, including 30.1% of
high school students and 11.7% of middle school students. Main
ENDS used were D-ENDS.
2021-
22
UK(21) From January 2021 to April 2022, there was an 18-fold increase in
the number of vapers using D-ENDS, rising from 1.2% to 22.2%.
Growth in D-ENDS was most pronounced in younger adults: for
example, the percentage of 18-year-old vapers using D-ENDS rose
from 0.4% to 54.8%
Marke�ng of disposable cigarete,
Marke�ng of so-called newer products (snus, nico�ne pouches, ENDS, D-ENDS, HTPs) use a variety
of marke�ng techniques. D-ENDS appears to target mostly younger people through social media
channels like FB, TikTok, Instagram, etc. In the UK, TikTok is used by half of eight to 11-year-olds and
three-quarters of 16 to 17-year-olds. The marke�ng “mix” can change from country to country.
Social media is widely used by young people with user-generated content. Influencer marke�ng is
par�cularly influen�al in promo�ng products. Of concern is the fact that the vast majority of
YouTube and Instagram content about ENDS promotes their use, and typically the content does not
contain age and/or health warnings. These findings may highlight a priority for governmental policy
to restrict the ability of marketers to reach youths with social media content promo�ng ENDS. (22)
Social media marke�ng is some�mes linked to industry paid influencers which makes it even more
difficult to follow and dis�nguish between paid and non-paid content. Some industries appear to
run well-funded and planned marke�ng campaigns, mixing marke�ng methods, including the use
of influencers, and print or online ar�cles.

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Image 2: D-ENDS advertisement in TikTok, The Guardian, 17.07.2022
An inves�ga�on in the UK recently revealed that Chinese-owned brand Elf Bar is fuelling the boom
in D-ENDS among young people as social media influencers on TikTok promote its goods in an
apparent breach of adver�sing rules. (23)
D-ENDS products themselves use shape, design, colours, and flavours to atract a young customer
base.
Image 3: some examples of D-ENDS particularly aiming young people.
D-ENDS flavourings play a par�cularly important role in their appeal to youth. The flavour “tobacco”
is seldom used. Most flavours are fruity or sweets, with o�en an addi�on of menthol or “icing”
flavours. (24) The very common brand Elf bar 600 is normally available in at least 40 different
flavours, with new flavours constantly appearing. Some examples of flavours are apple peach,
banana ice, blue razz lemonade, cherry cola, classic cola, energy ice, lemon tart, kiwi passion fruit
guava, strawberry energy, watermelon bubble-gum, etc. Some flavours are an improbable new mix
with a strange name, like the “Elf Berg” which is described as mixing “a selec�on of juicy-tas�ng
berry notes with icy menthol, for a vape that’s as fruity as it is frosty”. Special flavours are produced
for special occasion in “limited” offers, for instance for the 2022 Christmas holidays, Elf bar
produced flavours like cinnamon orange, red velvet cake or chocolate brownie cookies for some

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European markets. It is noteworthy that China has banned the sale of electronic cigaretes with
non-tobacco flavours since 1 October 2022. (4)
Health and environmental impact
Disposable ENDS pose a major environmental threat. They contain plas�c, metals, toxic e-liquids,
and also a batery (usually ion-lithium), which are typically improperly disposed. While the batery
could theore�cally be recharged, the devices are designed to be thrown away a�er the e-liquid
content is consumed.
Producers and distributors have made limited efforts to inform consumers on how to properly
dispose of their D-ENDS products. Where such informa�on exists, it is scant, poorly visible,
some�mes wrong, and incomplete. Very few distributors accept the return of used devices, and it
is unclear how they dispose of them if they collect them. Most, if not almost all, such devices end
up either in the environment or in normal rubbish (household rubbish) and not in special toxic
electronic rubbish, as they should. (25) In the UK, research from the recycling group Material Focus
claims that 1.3 million single use vapes are being thrown away every week. That means every year
10 tonnes of lithium bateries inside the electronic cigaretes are also being discarded — that's the
same amount of lithium needed for 1200 electric car bateries. (26)
D-ENDS are single use plas�c and electronic devices that should, if possible, be banned from the
market, for environmental reasons. If not banned, a compulsory recycling system should be
enforced by governments.
NB: in this document we are not discussing the health risks of ENDS, D-ENDS, or their possible risks
compared with other nico�ne and tobacco products. We simply note that evidence showing their
nega�ve health and environmental impact is growing. (27)
Research gaps
Many research gaps exist regarding disposable ENDS and ENNDS.
Chemical analysis: an important aspect to be considered is their extreme heterogeneity and
diversity: while D-ENDS devices are rela�vely simple and easy to produce, their chemical contents
are poorly analysed. Chemical analysis of the liquids and of the aerosols generated by their
consump�on should be carried out. Liquids heated at high temperatures are crea�ng novel and
poorly understood chemical compounds. When a D-ENDS is exhaus�ng its e-liquid, the metal coil
appears to be hea�ng more and more. How this is affec�ng the aerosol generated by the D-ENDS
has not been studied. Flavouring chemicals are also poorly understood, and more research is
needed on their specific toxicity.
Health impacts: increasing evidence of the health impacts of these products is emerging, however
there are s�ll many gaps in the medium- to long-term. D-ENDS allows a strong intake of nico�ne
(very o�en nico�ne salt and synthe�c nico�ne are used in these products) in a very short �me (to
get a “hit”) and young people could hyperven�late with a D-ENDS. Nico�ne has specific health

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implica�ons for young people, par�cularly in rela�on to the development of addic�on, but how
this stronger intake can affect young people’s physical health is s�ll being researched.
Surveillance and monitoring: monitoring efforts to clearly differen�ate prevalence of different
products (i.e. differen�a�ng between open systems ENDS, pods ENDS and disposable ENDS),
started only recently so surveillance data is scant. Mul�ple products’ prevalence and interac�on
among product consump�on is o�en insufficiently considered.
Market surveillance: markets are evolving very rapidly and there is an urgent need to follow their
evolu�on. What products are available in different markets? How have big producers adapted
their marke�ng strategies? How are prices evolving? Commercial determinants of health should
be fully integrated in public health strategies.
Policy analysis: many policies effec�ve against tobacco should be implemented against disposable
ENDS as well (plain packages, flavour bans, taxa�on, full adver�sement bans, selling only under a
licence system, etc.) However, regula�on and policies o�en differ between tobacco or ENDS
products. What is the impact of policy differences? How should ENDS and D-ENDS, if allowed on
the market, be taxed in comparison to other nico�ne and tobacco products?

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