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Views And Reviews

The prominence of e-cigarettes is a symptom of decades of failure to tackle smoking properly

BMJ 2019; 364 doi: (Published 14 February 2019) Cite this as: BMJ 2019;364:l647
  1. Nicholas S Hopkinson, reader in respiratory medicine, medical director12
  1. 1National Heart and Lung Institute, Imperial College London, UK
  2. 2British Lung Foundation, UK
  1. n.hopkinson{at}
    Follow Nick Hopkinson on Twitter @COPDdoc

There is a danger that debate around e-cigarettes drowns out the work needed to implement the full range of tobacco control measures

The annual Public Health England SmokeFree Health Harms campaign, now in its seventh year, focuses on the toxins present in cigarette smoke and their harmful effects on the body. A novel feature this year is emphasis on the relative safety of e-cigarettes compared with smoking. A video shows sticky yellow black sludge appearing after a few packets of cigarettes are smoked through a simulator. The same noxious material is being deposited in the lungs of smokers and the shock value of the “jar of tar” is a familiar tool. By contrast, there is no such accumulation of tar from an equivalent quantity of e-cigarette vapour. The levels of carcinogens found in people who vape are much lower than those seen in smokers,12 data which underpin estimates that vaping is no more than 5% as harmful as smoking, and that completely switching from smoking to vaping is associated with substantial health benefits.3

There are now more than 3 million people in the UK who vape.4 …

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