Intended for healthcare professionals

Head To Head

Should electronic cigarettes be as freely available as tobacco? Yes

BMJ 2013; 346 doi: (Published 14 June 2013) Cite this as: BMJ 2013;346:f3845
  1. Jean-François Etter, professor
  1. 1Institute of Social and Preventive Medicine, Faculty of Medicine, University of Geneva, Switzerland
  1. Jean-Francois.Etter{at}

The Medicines and Healthcare Products Regulatory Agency has decided to license electronic cigarettes as medicines from 2016. Simon Chapman (doi:10.1136/bmj.f3840) agrees with regulation, seeing e-cigarettes as another way for big tobacco to try to make nicotine addiction socially acceptable again, but Jean-François Etter says restrictions will result in more harm to smokers

At last smokers have a safer alternative to tobacco. The law in most countries allows the presence of nicotine only in tobacco and in drugs (for example, nicotine replacement therapy patches and gum), effectively prohibiting competitors to tobacco and drug companies from entering the drug market. Because drugs that contain nicotine are unattractive and not very effective,1 people addicted to nicotine tend to use tobacco. Arguably, the laws regulating nicotine cause millions of deaths and unjustifiably protect existing nicotine suppliers at the expense of more innovative competitors, who could devise safer products.

However, electronic cigarettes are about to change this. These products are very successful: sales of e-cigarettes in the United States have doubled every year since they were introduced in 2007.2

Harms of regulation

Until recently, e-cigarettes were able to fly under the legislative radar and the sale of nicotine containing e-cigarettes, although not in compliance …

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