Impacts of e-cigarette regulation via the EU Tobacco Products Directive on young people's use of e-cigarettes: a natural experiment

Impacts of e-cigarette regulation via the EU Tobacco Products Directive on young people's use of e-cigarettes: a natural experiment The EU Tobacco Products Directive 2016 (TPD) introduced a number of new restrictions on e-cigarettes in the UK. Most advertising is now banned and, from May 2017, all products containing nicotine are required to carry health warnings on 30% of the surface of the packet. The overall aim of this study was to gain an understanding of how policy actions such as these impact on young people’s knowledge, perceptions and use of e-cigarettes. This National Institute for Health Research (NIHR) funded study involved a UK-wide research collaboration involving the Universities of Cardiff, Stirling, Glasgow and Bristol and included two key strands of work. Firstly, routinely collected survey data from England, Scotland and Wales was used to test the effects of TPD legislation on young people's use of e-cigarettes. Secondary analysis of this survey data examined whether a trend toward growth in e-cigarette use among young people was stunted or reversed by this legislation. Secondly, the research team conducted a mixed methods process evaluation, including group based interviews with young people in secondary schools, conducted during a transitional period when unregulated e-cigarettes could still be sold (up to May 2017) and again a year later, after a period of full compliance. Interviews were also conducted with key stakeholders including representatives of government and third sector organisations involved in tobacco control policy-making, local government trading standards officers and e-cigarette retailers. Additionally, an audit of e-cigarette products to assess compliance with the TPD was conducted on retailers’ premises, within each country, before and after the compliance date. Several publications from the study have been published in peer-reviewed journals, including Tobacco Prevention and Cessation and the International Journal of Drug Policy. The study team expect to submit their final report to the funder towards the end of 2021.