Israel ponders modalities for banning e-cigarettes

Faced with the very rapid growth of vaping among young people, the Israeli government is considering several options, ranging from banning all e-cigarettes to prohibiting characteristic flavors and requiring graphic warnings on standardized packaging.

The very rapid growth of vaping among young people and adolescents who have never smoked is of great concern to the Israeli authorities. The consumption of e-cigarettes has in fact increased threefold among adolescents aged 12 to 14 in the space of a single year. The death, on April 15, 2023, of a 16-year-old adolescent suffering from respiratory failure caused by several years of vaping[1], and the hospitalization of another 16-year-old two weeks later for the same reason[2] have also strongly moved public opinion.

A possible gateway effect from electronic cigarettes to smoked tobacco

A study by Smoke Free Israel published in 2022 revealed that smoking prevalence has doubled in four years among adolescents aged 15 to 17. The study establishes a link between the early initiation of adolescents to e-cigarettes and the establishment of regular tobacco consumption, and concludes that there is a bridging effect between these two types of products, both in adolescents and adults.[3]Electronic cigarettes are particularly criticized for reducing the nicotine experimentation phase and for inducing addiction more quickly.

Raising awareness of the dangers of vaping and considering restricting this trade

These data and events initially led the Minister of Health to order a campaign to prevent vaping among young people, as well as to disseminate a care program aimed at facilitating weaning from electronic cigarettes among adolescents.[4].

The Minister of Health is also evaluating different options to counter the growth of electronic cigarettes. One of them would be a complete ban on the sale of electronic cigarettes, as has already been decreed by more than 48 countries.[5]This line is supported by the Israeli Cancer Society, while the World Health Organization (WHO) recommends regulating e-cigarettes where they are not banned.[6].

Other options being considered include banning all characteristic flavours in e-liquids for electronic cigarettes or making it mandatory to display graphic health warnings on the packaging of all vaping products. strong measures Recently adopted laws in Australia banning imports and restricting the sale of e-cigarettes are also among the possible hypotheses.

A voluntary policy on tobacco and vaping products

These vaping restrictions are not entirely new in Israel, as the country had already banned JUUL e-cigarettes in 2018, on the grounds that these products contained more than 20 mg/ml of nicotine.[7]. They go hand in hand with provisions on the fight against smoking in the strict sense. In 2022, Israel adopted a law aimed at revitalizing the fight against smoking. This law included raising the legal age to 21 for purchasing tobacco products, banning smoking on balconies and measures to protect against tobacco industry interference.

Keywords: Israel, electronic cigarettes, gateway effect, plain packaging.

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[1] Siegel-Itzkovich J, 16-year-old Israeli dies after e-cig caused collapsed lung, The Jerusalem Post, published April 16, 2023, accessed May 12, 2023.

[2] About two weeks after Maiden Keller's death: Another teenager was hospitalized after using electronic cigarettes, MivzakLive News, published May 2, 2023, accessed May 12, 2023.

[3] Kislev, Shira & Kislev, Mickey. (2022). Smoking in Israel 2022: The Characteristics of Smoking among Adolescents, Youths and Adults. 10.13140/RG.2.2.28034.15049/1.

[4] After 16-Year-Old Vaper Dies Of Lung Failure, Israeli Health Ministry Promotes Campaign Against Electronic Cigarettes, VINnews, published April 19, 2023, accessed May 12, 2023.

[5] Israel: Health Ministry Considers Banning E-Cigarettes, i24News, published May 5, 2023, accessed May 12, 2023.

[6] What are the policy options for regulating ENDS?, in Tobacco: E-cigarettes, WHO, published May 25, 2022, accessed May 12, 2023.

[7] Williams D, Israel bans Juul e-cigarettes citing 'serious' public health risk, Reuters, published August 21, 2018, accessed May 12, 2023.