The World Health Organisation has issued a report calling for tougher regulation on e-cigarettes, including a ban on indoor use.

The agency’s analysis looks at the health impacts of electronic nicotine delivery systems (ENDS), the use of which is “apparently booming”. It is estimated that there are nearly 470 brands and in 2013, $3 billion was spent on ENDS globally.

The WHO is far from convinced about the benefits of these products, noting that most have not been tested by independent scientists and “limited testing has revealed wide variations in the nature of the toxicity of contents and emissions”. The report expresses concern about the health risks from nicotine exposure, stating that reports from the USA and the UK indicate that the number of reported incidents involving nicotine poisoning “has risen substantially as the use of ENDS has increased [and] the actual number of cases is probably much higher than those reported”.

The report states that “the evidence is sufficient to caution children and adolescents, pregnant women, and women of reproductive age about ENDS”. It goes on to recommend that devices should be regulated to "minimise content and emissions of toxicants".

It questions claims that e-cigarettes help people quit smoking as “their efficacy has not been systematically evaluated yet” and expresses concerns that the ENDS market is “increasingly owned by the tobacco industry”, which has vested interests. Th report calls for a ban on products that contain “fruit, candy-like and alcohol-drinks flavours”, recommending that vending machines should be removed from “almost all locations”.

The WHO also wants a ban on indoor smoking and on any health claims until products provide "convincing supporting scientific evidence and obtain regulatory approval".

The WHO report came hours after the American Heart Association issued its first policy statement on e-cigarettes, saying they are dangerous because they target young people, can keep people hooked on nicotine, and threaten to ‘re-normalise’ tobacco use. The US Centers for Disease Control and Prevention also echoed that stance and along with the AHA has called on the US Food and Drug Administration to stiffen regulations against ENDS.