Letters Divisiveness of e-cigarettes

Regulating e-cigarettes to help them realise their potential as an anti-smoking tool

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h3767 (Published 23 July 2015) Cite this as: BMJ 2015;351:h3767
  1. Lawrence O Gostin, faculty director1
  1. 1O’Neill Institute for National and Global Health Law, Georgetown Law, Washington, DC 20001, USA
  1. gostin{at}law.georgetown.edu

Gornall’s article captures the substance and passion of the controversy over e-cigarettes.1 But debates over exactly how harmful e-cigarettes are and about their role in smoking cessation or youth nicotine initiation are an unnecessary distraction and a harmful diversion.

Lindblom suggests that, on the basis of what is already known, it would be possible to agree on core goals for regulating e-cigarettes as a way to reduce unnecessary risks from e-cigarettes and their marketing and to enable e-cigarettes to realise their potential as an anti-smoking tool.2 Two components of that approach would be to make e-cigarettes as minimally harmful as possible and to restrict their marketing and sale, as much as is practical, to current smokers and those who have switched.

The current divide over e-cigarettes also obscures a more important fact: e-cigarettes make anti-smoking policies that have been considered too controversial or extreme, such as minimising nicotine levels in cigarettes or even banning them, much more politically viable. Thanks to e-cigarettes, smokers who still do not quit would have ready access to an acceptable, legal, at least somewhat less harmful way to continue feeding their addictions by inhaling nicotine. This would reduce concerns about smokers turning to illicit cigarettes or overwhelming limited cessation and treatment resources.3

Rather than try to resolve the current controversy (which could take years), we should use what we already know about e-cigarettes to regulate them effectively, while taking advantage of their availability to promote and implement much more aggressive anti-smoking policies.


Cite this as: BMJ 2015;350:h3767



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