Should doctors celebrate the rise of e-cigarettes and other alternatives?

News & Analysis

9th September 2016

E-cigarettes are now the most popular way to quit smoking – more than gums, patches or sprays. Yet they go against medical dogma, which is to promote abstinence. This is because many people use them with no intention of giving up. This model views e-cigarette users as addicts – they are still addicted to nicotine, just as they were when they were smoking regular cigarettes.

Should doctors be relaxed about this addiction, or should we, as in the past, continue to push for abstinence?

The latest figures show that about 18 per cent of people still smoke in England. That number has fallen in the past 10 years from 24 per cent. But what’s concerning is that the number of people who have tried to quit in the past year has fallen from 42 per cent a decade ago to just 31 per cent. Fewer people are smoking, but of that number fewer people are trying to give up. So we’re left with a hardcore group of smokers. Is telling them to quit the answer? If we can move them on to alternative sources of nicotine, isn’t that better?

To try and find the answers to these questions I spoke to: Professor Clare Gerada, the former chair of the Royal College of General Practitioners; Dr Roger Henderson, a GP in Shropshire who writes regularly for Spectator Health; Professor Dinesh Bhugra, former president of the Royal College of Psychiatrists and president of the World Psychiatric Association; and Moira Gilchrist, director of scientific engagement at Philip Morris.

Dr Max Pemberton is the editor of Spectator Health.


  • Professor Gerada seems to totally believe in the dogma of excessive addictiveness of nicotine. How does she explain a phenomenon, that me and many other long term vapers have noticed?
    Diminishing Dependency

    Yes, I know, that’s just “anecdotes”.

    But thousands of similar anecdotes are a wealth of empirical data that no real scientist should cavalierly dismiss.

  • Bill Tarling

    Not really impressed with the video overall, mainly because they approach the topic as if nicotine addiction is the sole purpose for vaping. They never examine levels, equipment differences for better efficiency or delivery, or (for those like myself) ex-smokers who switched to vaping and have a continued preference for no nic juices in our personal use…

    Not everything is about nicotine addiction — especially when it’s not the nicotine from cigarettes that was the major addiction factor on its own, but rather it included all the nic effect boosters in tobacco and cigarettes that made it more addictive.

    They also don’t cover how small a dosage level current vape liquids are in relation to the boosted nicotine found in cigarettes.

    Last quarter of the video sounds more like a PR commercial by [sponsor] Phillip Morris International as well

  • Robert Innes

    This is my own personal story which I have recounted in the Vaping post… http://www.vapingpost.com/2016/08/02/hooked-netted-landed-a-smokers-story/

  • Brian Coe

    Well Clare Gerada got on my nerves within the first 10 seconds, that approach and attitude is outdated and proven not to be the case that in her words ” it’s an addiction drug ” forgetting the principle of the ” dose makes the poison” nicotine by it’self isn’t addictive otherwise many millions of vapers wouldn’t be able to lower there intake – self titration, with tobacco this isn’t as easy to do because of the influence of the 4000 + other chemicals, she talks about ” free from that addictive behaviour ” not needing a cigarette or E-cig but I wonder if she drinks or in the morning needs the cup of Tea or coffee !! where do we draw the line on addiction ?

    The problem we have with some medical professions on vaping is lack of knowledge of vaping products, how they work and more importantly meeting the people who have been smoking 40 years and 40 cigarettes a day who have quit smoking by switching to vaping, is someone like this Clare Gerada qualified to say no sorry that’s not good enough, either quit or die!! This needs to be addressed where attitudes towards harm reduction needs to be encouraged and not discouraged by idiot Medical professions like Clare Gerada.

  • Greg A. Hamacher

    If they are so worried about addiction where is the group to stop people drinking alcohol? Alcohol is damaging to the liver and brain even in small amounts and people that abuse alcohol not only damage themselves but endanger others. No this whole thing is not about nicotine and addiction, not public health, or the children, or second hand vapor, it is about money and taxes, that is the bottom line period!