[Perspectives] Electronic cigarettes and history

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Electronic cigarettes are currently the subject of much public, media, and regulatory attention. Discussion centres on whether e-cigarettes encourage or discourage smoking. Should they be banned? Should they be regulated as consumer products, tobacco products, as medicines, or a combination of approaches? It seems likely that some countries will opt for the EU approach of regulation as a tobacco product, whereas others will go for medicines regulation which allows claims about smoking cessation to be made. The recent entry of the tobacco industry in the e-cigarette market has caused concern among some public health interests, not least because it enables the industry to present products for medicines regulation and to circumvent the restrictions in the Framework Convention on Tobacco Control on industry engagement with policy makers. Other medical experts have called on WHO to resist the urge to control and suppress e-cigarettes. This seems to be an issue that has blown up very recently. But responses to e-cigarettes can only be understood in the light of longstanding tensions and debates about smoking and public health. The battle lines currently drawn are imbued with history. Two key historical areas that frame the debate are attempts since the 1950s at product modification to achieve “safer smoking”, and the changing status of nicotine in relation to tobacco since the 1970s.