The e-cigarette: Opportunity or threat?

First published: 30 March 2019 | Last updated: 20 May 2019


Deborah Arnott

Chief Executive

Deborah Arnott is Chief Executive of Action on Smoking and Health, honorary associate professor in the Division of Epidemiology and Public Health at the University of Nottingham, honorary fellow of the Royal College of Physicians and a member of the RCP’s Tobacco Advisory Group. She is a recognised national and international expert on tobacco control and the WHO Framework Convention on Tobacco Control with a particular interest in nicotine regulation and harm reduction. She was a member of the NICE Programme Development Groups which developed guidance on smoking cessation and tobacco harm reduction and of the Commission on Human Medicines expert advisory group to the MHRA on nicotine containing products. In 2007 she was awarded the Alwyn Smith Prize presented by the UK Faculty of Public Health to the person judged to have made the most outstanding contribution to the health of the public.

The debate over the opportunities and threats offered by electronic cigarettes as a harm reduction tool has been heated, both in this country and internationally, since they became identified as a ‘disruptive technology’ which for the first time threatened the dominance of tobacco as a nicotine delivery device. This presentation will set out the key arguments, for and against electronic cigarettes, and examine the evidence that underpins these arguments, including at population level.  Some of this will be drawn from ASH surveys of adult and youth smoking attitudes and behaviour.  It will also examine how policy makers in the UK were engaged in the debate on harm reduction in tobacco use for years before electronic cigarettes appeared on the market. This explains why the UK has been, and continues to be, in a better place to develop a rational policy on tobacco harm reduction than other jurisdictions.  While tobacco is in many ways unique, for example having an international health treaty governing its use, there are similarities with other addictive substances, particularly alcohol, and there may be lessons for other areas on how to ensure a productive science policy relationship. ASH is core funded by the British Heart Foundation and Cancer Research UK, and has received project funding from the Department of Health for work to support implementation of the government’s tobacco control policies. ASH does not receive any commercial funding.


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Deborah Arnott