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Several mechanisms have been proposed to explain the increased odds of COPD in e-cigarette users

It sets minimum dimensions for warnings and eliminates small packages for certain tobacco products, bans all promotional and misleading elements on tobacco products, introduces EU-wide tracking and tracing to combat illicit trade of tobacco products, allows EU member states to prohibit internet sales of tobacco and related products, sets out safety and quality requirements for consumer electronic cigarettes, and obliges manufacturers to notify novel tobacco products before placing them on the EU market

Breslau N, Johnson EO, Hiripi E, Kessler R

But McKee says women are more likely to smoke to cope with stress, not to get those feel-good signals