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Hospitals are wrong to ban e-cigarette use

BMJ 2015; 351 doi: (Published 30 September 2015) Cite this as: BMJ 2015;351:h5063

Re: Hospitals are wrong to ban e-cigarette use

The author's argument is fundamentally the same as the point made in 2013 by J.-Fr. Etter in his Editorial: there should be no regulation of E-cigarettes, because by this new technology of administering Nicotine, the tobacco epidemic will cease by itself, since nicotine dependent persons will switch to the cheaper and safer product and quit tobacco consumption. Thereby, by the dynamics of the free market the tobacco epidemic will decrease and finally die by itself.

There are fundamental flaws in this proposed "logical argument":

1. E-Cigarettes are not as good as conventional cigarettes for administration of Nicotine; that's the reason, why they are not useful for smoking cessation.

2. It is naive to believe that the tobacco industry, having heavily invested in the E-Cigarette Market, will do so, in order to help their dependent customers to stop to buy and to use the "real thing" (the tobacco Cigarette). It is rather plausible that they push this product for promotional reasons (what nicer thing than a movie star with a E-cigarette banalizing smoking and vaping) and for banalizing Nicotine consumption.

3. Banalizing Nicotine and Nicotine consumption will finally result in more Nicotine addicts....and therefore in more people trying the best way to get the drug into their brain, by the tobacco cigarette. Since Big Tobacco will certainly manage the drug-nicotine tobacco-"disinformation on health-beliefs"-system in order that their original product (i.e.the tobacco Cigarette) will dominate the Nicotine/tobacco market. Money will always be stronger than anything else, and certainly stronger than the logic of an ethics expert.. -- The harm reduction song has already been sung to us, precisely by Big Tobacco, when they sold to the public , and they succeded to make us beliefe in, "milder Cigarettes", with huge economic success, but no proven harm reduction whatsoever. They are trying the same old game again.... This time they seem to have instrumentalized professionals from the Ethics field to preach their gospel....and to make them forget that the fundamental ethical rule for doctors and hospitals is to do NO harm; and in this case this means not to endorse the rather unsafe, unregulated, unstandardized device called E-cigarette under the unproven token, that it would be "less harmful".

Competing interests: No competing interests

06 October 2015
Rainer Martin Kaelin
pulmonologist in private practice
(former affiliation) to Boston University medical school, Geneva universitiy hospital
CH 1110 Morges