Letters Divisiveness of e-cigarettes

Why we shouldn’t normalise the use of e-cigarettes

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h3770 (Published 23 July 2015) Cite this as: BMJ 2015;351:h3770
  1. Michael Craig Watson, associate professor in public health1,
  2. Mark Forshaw, subject leader in health and applied psychology, natural sciences, and psychology2
  1. 1University of Nottingham, Faculty of Medicine and Health Sciences, D86, Queen’s Medical Centre, Nottingham NG7 2HA, UK
  2. 2Liverpool John Moores University, Liverpool, UK
  1. michael.watson{at}nottingham.ac.uk

We welcome Gornall’s article because we think it will promote much needed debate about an important public health concern.1 However, many of the issues covered are not new. More than 30 years ago, Taylor published a seminal book that provided a comprehensive insight into the world of public health politics.2 The Smoke Ring discusses the political and economic interests surrounding the tobacco industry, and for those who are unsure about the goals and tactics of certain multinational companies it is worth reading.

Tobacco companies have tremendous financial and political powers and, despite the overwhelming medical evidence against traditional cigarettes, companies are still able to sell their products. Moreover, certain markets are expanding.

It is important to reiterate that tobacco smoking is the largest single preventable cause of ill health and death.3 In the UK the reduction in smoking is a great public health success story, but it is important that this achievement is not reversed.

E-cigarettes are increasingly popular, and high street vendors and local and national advertisements have already been established, potentially contributing to the perceived normalisation of this activity. The widespread use of e-cigarettes has the potential to act as a gateway to traditional cigarettes.

The Institute of Health Promotion and Education has a position statement on e-cigarettes with five clear recommendations4:

  • E-cigarettes should be seen as a part of the armoury of devices intended to wean smokers away from cigarettes, and nothing more

  • E-cigarettes should not be promoted to non-tobacco users

  • More research is needed into the efficacy of e-cigarettes

  • Further debate about the use of e-cigarettes in public places (including workplaces) is needed

  • Careful monitoring of the promotion and use of e-cigarettes is needed.


Cite this as: BMJ 2015;351:h3770



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