Scientific Controversy, Issue Salience, and E-Cigarette Regulation: A Comparative Study of Policy Debates in Germany and England

Electronic cigarettes pose a regulatory challenge to governments seeking to balance their potential risks and benefits in the absence of conclusive scientific evidence. This comparative paper aims to explain the presence and absence of controversy about e-cigarette regulation in England and Germany, respectively. It identifies three sets of factors that help explain why e-cigarettes regulation became highly controversial in England, while in Germany this debate has been almost entirely absent. These factors relate to (1) differences in the perceived salience of e-cigarettes resulting from existing tobacco control measures, prevalence of e-cigarette use, the presence of the tobacco industry, and the role of public health community in public debate; (2) differences in institutional context and pathways of policy-making; and (3) differences in approaches to legitimize policy decisions through science and the judiciary. The paper highlights the complex interplay of political, institutional, and cultural factors in explaining differences in public health decision making.