English study challenges American consensus on e-cigarettes

Research from Public Health England, the English equivalent of the American CDC, suggests e-cigarettes are 95 percent less detrimental to health than traditional cigarettes — a finding which opposes that of U.S. health officials who almost invariably condemn the practice of e-puffing.

A recent perspective piece in The New England Journal of Medicine, examines the dichotomy between American and English views on the e-cigarette.

When the PHE report was published in August of 2015, it was initially endorsed by the United Kingdom public health community, then quickly denounced in British publications like the Lancet and the British Medical Journal. Twelve prominent U.K. public health organizations, including Cancer Research U.K. and the British Lung Foundation, came to the defense of PHE. Their joint press release stressed a public health obligation to encourage smokers to switch to e-cigarettes.

While English health policy seems driven by harm-reduction tactics, American opinion is dominated by the desire for tobacco abstinence.

The CDC warns that smokeless cigarettes could be associated with health risks, and an American organization, Campaign for Tobacco-Free Kids, plainly condemns the use of e-cigarettes. In direct contrast, the chairman of the U.K. anti-tobacco organization Action on Smoking and Health said it would be "a public health tragedy if smokers were discouraged from switching to electronic cigarettes."

The authors of the NEJM article posed the question, "Will England change the international conversation about e-cigarettes? The answer will depend, in part, on what the evolving evidence suggests, and it may take years before the answers are definitive. In the end, the sorts of policies that are implemented will depend on whether whoever dominates the debate views harm reduction as opportunity or anathema."

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