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Please do the EU Nicotine Users Survey [ LINK ] and help to spread it far and wide, by sharing it on social media

Today ETHRA is launching a major survey. Published in the run up to the revision of the European Tobacco Products Directive (TPD), this is the only questionnaire to survey nicotine consumers, the people most affected by possible regulatory changes to nicotine products.

ETHRA, which brings together 22 European groups representing consumers of safer nicotine products, is launching this questionnaire today to examine nicotine use in Europe. ETHRA is calling for maximum consumer participation and is asking for consumers to do the survey and also to help with its distribution, by sharing it on social media. The questionnaire is open to adults only and has been translated into 11 languages. The development of the survey is the result of collective voluntary work of ETHRA with the support of its scientific advisors.  ETHRA is independent from the nicotine and pharmaceutical industries.


The survey asks questions about the use of different nicotine products in order to discern conditions for users across Europe. The practical consequences of possible regulatory changes are also examined. How would you react to increased taxes, vape flavour bans or to the legalisation of snus? Is there a need for greater access to product information? Would lifting the container restriction on e-liquids have any impact? What is missing for people who want to quit smoking? These are some of the themes of the survey launched by ETHRA and its 22 member associations.

The questionnaire is available in Danish, Dutch, English, Finnish, French, German, Italian, Portuguese, Serbian, Spanish and Swedish. It takes only a few minutes to complete and is open until December 31, 2020. Access is restricted to adults only. Only one response is possible per IP address, to preserve the integrity of the survey. Please see the notes below for the survey link and QR code.  Please get in touch if you would like embedded links to include the survey on your website. 


The results of the survey will allow advocates of safer products to collect data on nicotine use in Europe, ahead of some key European Union (EU) regulatory deadlines. The European Commission is preparing proposals to amend two directives in 2021:

1. The Tobacco Products Directive (TPD), in which Article 20 deals with vaping as a related product, but prohibits the sale of snus in the EU, except in Sweden.

2. The Tobacco Excise Directive (TED) to harmonize definitions and tax treatment of new products, including vaping, at the request of the European Council. Almost 90% of citizens and organisations who responded to the Commission's public consultations in 2016 and 2018 had rejected the principle.

The proposed changes will be debated, by the Parliament in May 2021 for TPD, and by the European Council for taxes. Drawing up a concrete map of uses and needs based on the responses to the ETHRA survey will shed light on the issues of possible revisions and provide useful information for public, harm reduction advocates and, of course, decision-makers, particularly MEPs.


These issues concern tens of millions of Europeans: people who use safer nicotine products, people who smoke and who might switch to safer products, their relatives, and also social and health professionals in the field. Building reliable knowledge organically from users is an essential part of harm reduction approaches. This initiative is part of this successful strategy, being both about and with users.

We thank you for your participation and support.  Nothing about us without us.  



Note for transparency: SOVAPE, a not for profit association, has donated to ETHRA its subscription to the French EVALANDGO platform for this survey. EVALANDGO subscribes to the European regulation on data protection (GDPR) and data are stored in France.

ETHRA (European Tobacco Harm Reduction Advocates) promotes discussion and the exchange of information and potential actions to reduce exposure to tobacco-related harm. ETHRA complements existing organisations by offering European advocates a platform for exchanging information (particularly at European policy level) and for sharing experiences and local initiatives, in support of tobacco harm reduction. ETHRA is registered on the EU Transparency Register, registration number 354946837243-73.

Direct link:

QR code:

EU Nicotine Users Survey QR code








Please contact us if you would like embedded links for your website.








ETHRA partner the New Nicotine Alliance Ireland issued a press release yesterday in response to the Irish Heart Foundation’s (IHF) call for the introduction of a tax on e-liquid. We repost the press release below, with this introduction from NNA Ireland:

The rallying call to impose a tax on harm reduction products was made in the IHF pre-budget submission to the government, which was then circulated to newspapers on Monday in a press release. Protection of youth, which has become a mantra for those opposed to tobacco harm reduction, was yet again cited as the rationale. Ironically, repeated suggestions from NNA IE and vendors to introduce U18 legislation that would make it illegal to sell vapour products to under 18’s have been ignored.

Instead of a common sense approach that would directly address their concerns regarding youth, the plan from the IHF seems to be to punish adult vapers who have made the decision to greatly improve their health by switching from smoking to vaping, by adding extra expense to the products they depend on to remain smokefree. Vaping products are used by +200000 people in Ireland and have led to historically low levels of smoking. 

Figure 1 Healthy Ireland Survey 2019

Figure 2 Healthy Ireland Survey 2019

Press release: NNA Ireland response to the Irish Heart Foundation calls to tax e-cigarettes.

New Nicotine Alliance Ireland is an independent, consumer led, tobacco harm reduction association and registered charity, with the objective of promoting public health by means of tobacco harm reduction. We are entirely self-funded with no connections to any industry.

The Irish Heart Foundation is calling on the government to implement a tax on e cigarettes of 6c per mil in the forthcoming budget.

That’s a 10% increase on average on a bottle of e-liquid.

The New Nicotine Alliance Ireland is appalled at this call to increase the cost of quitting smoking. Given the reason for this is “e-cigarettes must be priced out of the purchasing reach of children and adolescents but remain affordable for adults who are using them as a smoking cessation device”, it strikes us as strange that the IHF would not call for a prohibition on sales to under 18’s first. Something the NNAI has called for and feels should be a priority.

“The smoking rate among 15 to 16-year-olds has been cut from 41% to 12% over a 20-year period. We cannot give up these hard-won health gains by allowing a new generation of children to become addicted to nicotine through an e-cigarette industry that is largely controlled by big tobacco,” Mr Macey added.

This is factually wrong, most e-cigarettes are independent products. Mr Macey seems to be basing his opinion on convenience store sales from the U.S.

“Some 22% of teenagers in Ireland have used e-cigarettes and whilst the international industry claims they are only intended to help long-term smokers to quit, branding that features cartoon characters, flavours such as candyfloss and bubble-gum and aggressive marketing tactics on social media platforms used by teenagers show this claim is preposterous.” The IHF seem to not understand that adults like flavors just as much as anyone.

Irish Heart Foundation head of advocacy Chris Macey added that “evidence showed that tax increases on e-cigarettes were effective in reducing youth use, but added that the Irish Heart Foundation did not want these increases to be of “a magnitude” that could push smokers trying to quit, back to cigarettes.” Interesting that the IHF recognises the effect of tax on smoking rates among adults but fails to realise that their proposed 10% rate is exactly the threshold where smoking increases.

Based on static models, every 10% increase in e-cigarette prices is associated with a drop in e-cigarettes sales of approximately 8.2%” Just to be clear, this is not just a drop of sales of e-cigarettes, it’s that many smokers going back to combustible cigarettes.

The same 10% increase in e-cigarette prices caused traditional cigarette sales to jump by 11%.

Less than 1% of teens are regular users of e-cigs, while 12% are regular smokers, focusing on the small issue seems like the IHF are missing the point. This is an historic low rate of teen smoking and it has happened while e-cigs are easily available and affordable. The IHF need to consider the consequences of restricting the most effective reducer of smoking rates and ask themselves if “proposing increasing funding to help smokers quit, including medications, smoking cessation services, the national quitline and mass media campaigns which currently totals 11.8 million euro, up to 50 million euro a year.” is value for money? These products have a failure rate of 90% E-Cigarettes have reduced the smoking rate to all time lows at zero cost to the taxpayer and a return to the exchequer of 21% vat?

“In its submission ahead of Budget day next Tuesday, the Foundation says that 17% of the population over 16, or some 680,000 people, are still classed as current smokers.”

“The number of current smokers in Ireland is continuing to fall, but to achieve a Tobacco-Free Ireland we need further net reductions of around 100,000 smokers each year for the next five years to hit the target,” said Mr Macey.

Smoking was 23% in 2015, 2016, then fell 6% largely thanks to vaping, which made up 38% of all successful quitters. Mr Macey’s proposed methods produced only 15% of all successful quit attempts according to the Healthy Ireland survey.

Perhaps if the IHF started promoting e-cigarettes as part of the options smokers could use to quit smoking and offered support, this 100,00 figure could be achieved.

Instead the IHF decided to punish the smokers who quit ‘the wrong way’ and punish the taxpayer with more money wasted on products that have such a high failure rate.



Photo by Sagar Patil on Unsplash









Photo by Sagar Patil on Unsplash

It was just a year ago when we launched European Tobacco Harm Reduction Advocates yet we have achieved much in that time.

ETHRA is powered by 22 European consumer groups, all dedicated to defending the rights for adults to use safer nicotine products, all signed up to ETHRA’s core principles. Working as a consortium of equal partners, we pool our expertise, our dedication, and our passion, and it has led to spectacular results. Our grouping is a voice for our partners who arrange their own revenue and who give their time to ETHRA for free, as we run it collectively and without funding.

Together we have aimed to amplify the Tobacco Harm Reduction (THR) consumer voice in Europe and highlight our commonalities while still celebrating our differences. We are very honoured to be supported in this endeavour by our Scientific Partners, all experts in the tobacco harm reduction field.

Our first year has exceeded our expectations.


Highlights of ETHRA’s first year

We gained recognition as stakeholders in the TPD review and participated fully in the stakeholder questionnaire process. As a result we produced notes on the subsequent stakeholder interview as a way of contributing an insightful consumer critique of this EU directive which has so much influence over our right to choose, use and enjoy safer alternatives to smoking.

We follow the TPD developments very closely and shine a spotlight on the opaque but critically important review process. Check out our TPD review article for a rundown of what is going into the TPD evaluation. A recent development is that the SCHEER preliminary Opinion has just been published and there is a public consultation which runs for 4 weeks. We will soon publish an article with guidance on how to respond to that. The Opinion is appallingly biased against THR and we simply cannot afford to ignore it.

We published the ETHRA manifesto with the tag #SayYesToTHR in May declaring the rights of safer nicotine users in Europe and on behalf of 27 million consumers. The manifesto was translated into our 16 partner languages - all available for download on our website.

We write to governments and submit to consultations, most recently to explain to the Dutch government why plain packaging for safer products is such a terrible idea.

We regularly publish news articles, to bring national issues to the attention of an international audience. Our most recent is a translation of Sovape’s shocking findings that 75% of French people do not know that vaping is less harmful than smoking. Accurate risk perceptions are fundamental to THR - if consumers do not know that reduced products are safer they will not want to use them. We also recently wrote about Europe’s Beating Cancer plan, urging for the initiative to embrace tobacco harm reduction and so empower smokers to take control of their own health. We submitted to the Cancer Plan public consultation earlier this year.

We sounded the alarm about the proposed flavour bans in Denmark and the Netherlands and galvanised consumers to act.  Flavours have emerged as a key battleground; expect many similar fights in the future.

At the height of the COVID restrictions we highlighted just how vulnerable access to safer alternatives to smoking is - people could buy combustible cigarettes everywhere but access to safer alternatives were heavily restricted, or even denied. This must change.


And the future?

We do not intend to relax after our successful first year, but instead to build on it. ETHRA’s Europe wide survey into consumer behaviour is coming soon. The survey will gather the opinions of those affected by possible changes in regulations to reduced risk nicotine products in the European Union. Help us celebrate our birthday by doing the survey and sharing it in your circles.

If you are in a grass roots THR consumer group based in Europe and support ETHRA’s principles, we would love to hear from you. So please get in touch if you are interested in partnering with us.

Follow our Twitter account and Facebook page, where we channel articles and opinion from all over Europe and beyond.

To finish, we would like to take this opportunity to give a huge thank you to everyone who has supported us and helped to make our first year such a successful one. Let’s make year 2 even better.



sovape logoPress Release - Thursday, 24 September 2020

BVA-SOVAPE 2020 vape and nicotine survey


The results of the new BVA-SOVAPE survey show that most French people still have false perceptions of the risks of vaping and nicotine. This is detrimental to public health and, because there has been no public information campaign to redress it, has not changed since 2019. Sovape, public health experts, addiction experts and smoking cessation experts are sounding the alarm.

How many smokers are discouraged from quitting because of false beliefs about effective alternatives? The French population’s state of misinformation about vaping and nicotine, as revealed by the BVA survey commissioned by the SOVAPE association, is very worrisome. Only 8% of respondents know that vaping massively reduces the risks compared to smoking. 78% mistakenly believe that nicotine is carcinogenic.

This perception of risk, which is contrary to reality, is a brake on people using vaping and nicotine substitution to stop smoking. In the absence of an adequate information campaign by authorities, the situation has not changed significantly since the previous BVA-SOVAPE survey in 2019.


75% of French people do not know that vaping is less harmful than smoking.

According to a new survey conducted in early September 2020 by BVA (see the report on Sovape website):

    • Only 8% of French people know that vaping is much less risky than smoking (compared to 7% in 2019 - 1%);
    • Only 23% think that it is a little or much less risky (versus 25% in 2019 + 2%);
    • 58% think that vaping is as much or more risky as smoking (vs. 59% in 2019 - 1%);
    • And 18% say they don’t know (versus 15% in 2019 - 3%).

Overall, 75% of French people are still mistaken about the risks of vaping compared to smoking.

Professor Gérard DUBOIS, member of the National Academy of Medicine, comments: “That less than one in ten French people know that vaping is much less dangerous than smoking, that nearly 2 in 3 French people think that vaping is as dangerous as smoking, and that 3 in 4 French people are mistaken is the disastrous result of criminal misinformation regarding the leading preventable cause of death in the world. (…) Vaping is one of the means to fight against the leading preventable cause of death: smoking. It is understandable that huge financial interests are dismayed to note that despite their efforts, smoking prevalence is falling in France. There is no doubt that if smokers, who for the most part want to stop smoking, knew exactly what is what, the effects would be even more spectacular. These are therefore avoidable deaths that are happening, and this is why misinformation is criminal in this area.”

Jean-Pierre COUTERON, Spokesperson for the Addiction Federation, contextualises: “At a time when so many of our fellow citizens are weakened by the economic and social crisis which is added to the Covid health crisis, not giving them the right information about the help that vaping can bring and not encouraging registration in self-support groups is a serious mistake - in terms of public health as much as in terms of harm reduction.”


No change in nicotine misperceived as a carcinogen

According to the new BVA-SOVAPE survey, 78% of French people believe that nicotine is carcinogenic (-2% compared to 2019).

However, nicotine is not a proven carcinogen for humans. “It is important that appropriate information is given to legitimise the use of nicotine, the primary active ingredient in replacement substitutes for smoking cessation," said Antoine Deutsch, from the French National Cancer Institute (INCa), at the October 2019 Vape Summit1. Unfortunately, this essential message remains unheard, due to a lack of media coverage.

Professor Benoit VALLET, from the School of Public Affairs SciencesPo Paris, declares: “This ‘erroneous perception’ amongst the French, the existence of which is reinforced this year, now not only merits strong investments in prevention messages from our national agency, but also research efforts in the human and social sciences to better understand this lack of knowledge and how it is maintained. Has the “tobacco and addictions” health insurance Fund already addressed this serious issue?”


Disinformation: a Detrimental Evil to Public Health

More than 96% of unassisted quit attempts fail. Nicotine substitution doubles the chances of success. Vaping doubles the chances compared to pharmaceutical substitutes. The combination of these aids with peer-support group follow-up can further double these odds, according to SOVAPE’s survey conducted during Tobacco-Free Month 20172. A 38% success rate of cessation at five months was measured in the follow-up of participants in the self-help group for smoking cessation with vaping on Facebook, now called INFO-VAPE3. Participants in the group are almost ten times more successful than those attempting to quit without help.

In the field, the demonisation of nicotine is detrimental to the work of helping people to quit smoking.

Doctor Valentine DELAUNAY says: “While giving smoking-cessation guidance to people who have already tried to quit smoking several times, I find that these people are still as uninformed as ever. They don’t know that smoking with a nicotine patch is possible, that vaping is a safe and validated tool for quitting, that it can be safely combined with nicotine substitutes (NRT). Only a large scale and repeated, coherent information campaign delivering these few key messages can reassure and inform French smokers.”

Professor Jean-François ETTER, from the Faculty of Medicine of the University of Geneva, estimates: “These misperceptions have public health consequences: because of this, fewer smokers are giving up cigarettes and switching to lower-risk products. Correcting these misperceptions will require a long-term effort, which will include informing the public and professionals (health professionals, journalists, policy makers, etc.), training health professionals in particular, and allocating the necessary resources.”


Restoring the Truth: An Emergency and an Ethical Necessity

Nearly 75,000 people die from smoking-related diseases in France every year. Offering appropriate information to smokers to give them a chance to quit is an ethical necessity. Independent vaping professionals are banned from “advertising and propaganda” and cannot counterbalance smear campaigns. It is therefore up to the competent authorities to assume their responsibility in this matter.

Professor Antoine FLAHAUT, Director of the Institute of Global Health at the University of Geneva (Switzerland) says: “It seems to me that it is the primary responsibility of governments to recognise the harm reduction potential associated with the consumption of safer nicotine products and to promote them effectively to cigarette smokers. That 75% of French people still believe that the electronic-cigarette is no less harmful than the cigarette is a level of misinformation that is highly detrimental to the health of smokers. The learned societies, Santé Publique France, and the Ministry in charge of health should take up this issue, so that this trend is quickly reversed and so that the vast majority of French people understand that the consumption of safer nicotine products is infinitely less dangerous to health than smoked tobacco, because it is the tars and carbon monoxide (CO) produced by the combustion of tobacco that cause the cancers and cardiovascular diseases induced by smoking.”

However, since SOVAPE sounded the alarm in October 2019, no adequate information campaign has been undertaken on the subject. The Covid-19 epidemic has certainly created an exceptional situation, however, these circumstances should not aggravate the situation by abandoning other health issues, especially the main preventable cause of disease which is smoking. There is an urgent need to set the record straight and give smokers every chance to stop.

Jacques LE HOUEZEC, scientist, smoking cessation expert and trainer, concludes: “It is the burning that kills, not nicotine, and not even tobacco itself. Burning any plant produces the same toxins as burning a cigarette (tars, carbon monoxide, fine solid particles and oxidising gases). Instead of properly informing smokers about these simple and verified facts, anti-smoking campaigns have always wrongly blamed nicotine. The result is there to see, and it seems to me that it is even worse than it was a few years ago. The misinformation about vaping has undoubtedly and unduly reinforced fears for smokers and non-smokers alike. It is essential that correct and honest information be given to the population concerning nicotine and the tobacco harm reduction in general.”


Find Sovape’s full press release, all the reactions and BVA’s survey report at [access]



(1) Videos from 3e Vape Summit, in French and in English [access]

(2) Report in french about vaping group during Mois Sans Tabac 2017 [access]

(3)INFO-VAPE website  [access]
     INFO-VAPE Facebook group [access]