Intended for healthcare professionals

CCBY Open access

Rapid response to:

Clinical Review State of the Art Review

What are the respiratory effects of e-cigarettes?

BMJ 2019; 366 doi: (Published 30 September 2019) Cite this as: BMJ 2019;366:l5275

Rapid Response:

Re: What are the respiratory effects of e-cigarettes?

Letter to the Editor,

In view of the deleterious effects noted by Gotts et al., one wonders why Public Health England continues to promote the usage of e-cigarettes to help smokers of cigarettes quit.

We in the healthcare profession are bound by the ethical principle of Do No Harm. Given the evidence presented in this review, using e-cigarettes to stop smoking introduces new unintended negative health consequences, not only those mentioned in the article, but possibly a new form of addiction which there is no known evidence-based means for e-cigarette cessation.

There are currently various means of helping cigarette smokers quit without the added risks mentioned in the article. The usage of nicotine replacement medications or other non-nicotine medications couples with effective counselling can greatly increase success in cessation of cigarette smoking without smokers adding to the list serious adverse risks of diseases mentioned in your article, including a new addiction.

Public Health England should reverse its decision because of the harm we now know and probably continue to discover as we navigate through this new industry induced world-wide epidemic.

Not only will we experience health related negative consequences due to the introduction of this novel technology, but we may have inadvertently introduced a new addiction –vaping - which presently there is no known evidence-based cessation methods to help those who are considering stopping vaping. It may turn out that vaping is much harder to stop, which, I believe, was not properly considered by those who advocate e-cigarettes as means of cigarette harm reduction intervention.

Competing interests: No competing interests

30 September 2019
Joseph Erban
smoking cessation counsellor
McGill - Jewish General Hospital Cancer Prevention Centre
3755 Cote-Ste Catherine Montreal, Quebec Canada H3T 1E2