“If you have MS you will be aware by now, particularly if you read this blog regularly, that smoking is bad for you. MSers who smoke do worse in the long-term than MSers who don’t; smokes enter the clinically apparent progressive phase of the disease earlier and have more rapid progression.”
“Not only does smoking increase one’s chances of getting MS on the first place, but if you have MS and you continue to smoke you are probably increasing your children’s chances of getting the disease via passive smoking.”
“Based on these observations you may have decided to stop smoking, or you may want to stop but can’t because you are addicted to nicotine. You may already have tried nicotine replacement therapy already in the form of gum or skin patches and failed. This is not surprising as these routes of administration don’t give your brain the necessary nicotine ‘hit’ it craves. What about electronic or e-cigarettes? E-cigarettes are much safer than ordinary cigarettes and administer nicotine the way the brain likes, and wants, it.”
Green et al. Perspective: Evidence, Policy, and E-Cigarettes — Will England Reframe the Debate? N Engl J Med 2016; 374:1301-1303.
….. The international landscape was dramatically reshaped in August 2015, when Public Health England (PHE), an agency of England’s Department of Health, released a ground-breaking report, “E-cigarettes: an evidence update.” With its claim that e-cigarettes are 95% less harmful than combustible cigarettes, the report attracted headlines internationally. It recommended that smokers who cannot or will not quit smoking tobacco try e-cigarettes and expressed great concern that the public perceived the two products as posing equal risks. Strikingly, the report underscored e-cigarettes’ potential to address the challenge of health inequalities, a central mission of PHE, stating that these devices “potentially offer a wide reach, low-cost intervention to reduce smoking and improve health in these more deprived groups in society where smoking is elevated.”….
……. Application of harm-reduction principles to tobacco products debuted in England in the 1970s, at the Institute of Psychiatry of the Maudsley Hospital. In 1976, Michael Russell, pioneer of effective nicotine-cessation treatments, famously wrote that “People smoke for nicotine but they die from the tar,” suggesting that one could satisfy a nicotine craving without risking the harms caused by smoking. Professional medical bodies in the United Kingdom endorsed a harm-reduction perspective……
……. 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…..