How e-cigarettes compromise children’s human rights

The new paper “How e-cigarettes compromise children’s human rights” by Tom Gatehouse and colleagues provides more evidence to inform e-cigarette policy making by reminding the delegates to the FCTC Conference of the Parties next week that they need to prioritize protecting kids over any “harm reduction” benefits for adults that the tobacco industry claims for adult smokers.

They make the very strong points that youth dominate the e-cigarette market: “the prevalence of e-cigarette use in children aged 13-15 is nine times that of adults” and warn that “the tobacco and nicotine industries have successfully influenced governments to downplay potential harms to a much larger group, which includes children.”

And there is only harm from this rapidly increasing youth use:

Most children and adolescents who use e-cigarettes have never smoked at the point they initiate use. For this group, the correct baseline with which to compare the effects of e-cigarette use is not tobacco smoking but breathing air. Applying this comparison, e-cigarettes are demonstrably harmful, with strong or moderate evidence of use among youths conferring increased risks of addiction, burns and injuries, anxiety, mood disorders, cough, throat irritation, asthma, and adverse cardiovascular measures. [citations deleted]

The problem is also global, making protecting the FCTC against e-cigarette companies: “While most e-cigarette users live in high income countries, … use is increasing among children and young people regardless of country income.”

Here are their Key Messages:

• Globally, children are now using e-cigarettes at higher rates than adults, largely because of the nicotine industry targeting youth
• Evidence indicates that most of this demographic had never smoked when they tried e-cigarettes
• Governments often overlook the harms to children, influenced by industry claims around reducing harm to adults who smoke
• International legal frameworks, including the WHO Framework Convention on Tobacco Control and the UN Convention on the Rights of the Child, can provide a legal basis for e-cigarette regulation which puts children’s health first

In addition to the points Gatehouse and colleagues make, it is important for everyone, including FCTC delegates and other policy makers, to keep in mind that we now know that e-cigarettes increase harm for adults, making the industry’s whole harm reduction argument moot.

The full citation is: Gatehouse T, Banks E, Toebes B, Alebshehy R. How e-cigarettes compromise children’s human rights BMJ 2025; 391 :e085850 doi:10.1136/bmj-2025-085850. It is available here.