Published in the American medical journal Annals of Family Medicine, an article  written by Ann McNeill, the Professor of Tobacco Addiction a the National Addiction Centre of the King’s College of London, United Kingdom, advises clinicians to recommend to their patients using electronic cigarette since they are the first most popular way British smokers quit smoking, the second most popular cessation method being “cold turkey”.
“On average, each cigarette smoked cuts someone’s life by 11 minutes“
In her article, the author explains that smokers go on smoking because of their need of nicotine which is brutally delivered in high dose when smoking and creates the hit that users need. In contrast, the delivery of nicotine by e-cigarette is smoother and allows sustaining brain’s demand for longer periods, which makes it much less addictive, delivered this way.
Despite the lack of scientific evidence on their effectiveness for smoking cessation, specialists’ comments and testimonies of ex-smokers converge to support ENDS as more efficient as placebo cigarette but also as more enjoyable in a cessation process than nicotine patches or gums.
Chemically, the vapor also contains harmful or potentially harmful compounds but in a much lower amount than in combustible cigarette, which makes tobacco specialists more prone to recommend e-cigarettes in a individual smoking cessation process.
Ann McNeill deplores that the discourse of health professionals do not pass the researchers’ messages on and keep patients in the doubt when it is not advising them not to use ENDS, making dubious and nonsensical arguments.
An illustration is provided in the article following McNeill’s in the editorial list of the same journal, Annals of Family Medicine, and signed by two clinicians . A four-point argumentation against e-cigarette says:
- “First, we lack strong evidence in regard to the safety of ENDS“
- “Second, the effectiveness of ENDS as a smoking cessation aid is questionable at best, potentially ineffective at worst“
- “Third, until regulations are approved by authorities, clinicians should pause for thought before recommending ENDS.“
- “Finally, the ethical duty of medicine is to do no harm.“
The authors’ arguments have been vigorously opposed point by point by Clives Bates in a public response to this article entitled “No credible case against advising smokers to switch to e-cigarettes“:
- “We lack evidence of the complete safety of anything, including medicines, and notably those used in smoking cessation.“
- “There are few RCTs [randomized control trials] evaluating these products because they are not medicines, but low-risk consumer alternatives to cigarettes.“
- “Regulation by the FDA is no guarantee of safety – many medicines have severe side-effects and cigarettes are regulated by the FDA under the Tobacco Control Act.“
- ‘first-do-no harm’ argument that made by the authors may “cause fewer smokers to switch and more e-cigarette users to relapse“.
 McNeill A., 2016. Should Clinicians Recommend E-cigarettes to Their Patients Who Smoke? Yes. Ann. Fam. Med. July/August 2016 vol. 14 no. 4 300-301. doi: 10.1370/afm.1962
 MeernikC., Goldstein AO., 2016. Should Clinicians Recommend E-cigarettes to Their Patients Who Smoke? No. Ann. Fam. Med. July/August 2016 vol. no. 4 302-303. doi:10.1370/afm.1961