Regulations to protect bystanders from exposure to e-cigarette aerosol in European Countries

Regulatory Approaches to Protect Bystanders from Exposure to Secondhand Aerosol of Electronic Cigarettes in European Countries (RASHA-E Study)


There is conclusive evidence that e-cigarette use increases airborne concentrations of particulate matter and nicotine in indoor environments compared to background level. Thus, harm to bystanders exposed to the exhaled aerosols might occur.  To minimise passive exposure to e-cigarettes aerosol, the WHO Tobacco Free Initiative provided policy suggestions for countries to regulate e-cigarettes including banning the use of e-cigarettes in places where smoking conventional cigarettes is already prohibited. In addition, Article 20 in European Union Tobacco Products Directive (EU TPD) 2014/40/EU regulates provisions on the safety and quality specifications for e-cigarettes which may also address the concern of their adverse health effects. However, little is known about the approach taken by European countries on specific regulation dedicated to protect bystanders from exposure to secondhand aerosol (SHA) of e-cigarettes and whether their approaches adhere to WHO recommendation and/or EU TPD.

Overall Objective

The main objective of RASHA-E study is to examine the policy made by the WHO European countries regarding restrictions on e-cigarette use in public places as a measure to limit passive exposure to SHA from e-cigarettes. Furthermore, we aim to do a comparative analysis among countries in accordance to their country-specific characteristics, EU membership, and tobacco control performance.


A cross-sectional survey for experts from 53 countries of WHO European region will be conducted. Among these countries, there are 28 European Union (EU) member states and 25 non-EU members (see full list of countries here: For each country, two policy experts will be required to provide information regarding national and subnational regulation on e-cigarette use in public places. Official documents related to the regulations will also be explored. The results will be described, summarised, and discussed within the national-and regional-level context.


April – October 2018

Financial Support

RASHA-E study is part of the TackSHS project funded by European Union´s Horizon 2020 Research and Innovation Programme.

Research Team



Amalia B, Fu M, Feliu A, Tigova O, Fayokun R, Mauer-Stender K, Fernández E. Regulation of Electronic Cigarette Use in Public and Private Areas in 48 Countries Within the WHO European Region: A Survey to In-country Informants. J Epidemiol. 2022 Mar 5;32(3):131-138. doi: 10.2188/jea.JE20200332.