
Cover image: Screenshot of the European Commission’s proposal for a Council Recommendation on cardiovascular health checks. | Source: European Commission / EUR-Lex
Key Points
EU Clarification: The European Commission told 2Firsts that its proposed cardiovascular health checks would assess smoking, vaping and smokeless nicotine product use as part of patients’ medical histories.
Member State Flexibility: The proposal sets out key indicators at EU level, while Member States may organise additional checks based on their healthcare systems and patients’ medical histories.
Tobacco Law Evaluation: The Commission also pointed to JRC research on e-cigarettes, heated tobacco products and nicotine pouches, saying the work had fed into the evaluation of EU tobacco legislation.
2Firsts
November 9, 2026
The European Commission has clarified to 2Firsts that its proposed cardiovascular health checks would include smoking, vaping and the use of smokeless nicotine products in patients’ medical-history assessments.
The Commission responded after 2Firsts sought clarification on an accompanying Q&A that referred only to “lifestyle factors” for adults aged 35 to 64.
In a written response, the Commission pointed to the annex of the proposed Council Recommendation, which lists “smoking, vaping and using smokeless nicotine products” alongside diet, physical activity, respiratory function and alcohol consumption.
Member State Flexibility
The Commission said the proposal sets out key indicators for consideration, while Member States may organise additional checks within their healthcare systems.
Further assessments may also depend on a patient’s medical and health history, it added.
The proposal is part of the EU’s broader Safe Hearts Plan, which covers cardiovascular disease prevention, early detection and treatment. The plan also lists the modernisation of tobacco-control legislation among its flagship initiatives.
JRC Study Fed Into EU Tobacco Legislation Evaluation

In the same response, the Commission pointed 2Firsts to a review by its Joint Research Centre examining e-cigarettes, heated tobacco products and nicotine pouches.
The Commission said the JRC work had fed into the evaluation of EU tobacco legislation. The review examines health outcomes associated with the three product categories, as well as evidence concerning smoking initiation and cessation.
2Firsts will continue to monitor EU regulatory developments concerning tobacco and nicotine products.
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