USA vs. England: e-cigarette public health policy highlights a big cultural divide.

Gavin-Giovannoni-150x150Professor Gavin Giovannoni
Department of Neurology
Royal London Hospital

“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.”

“The following perspective in this week’s NEJM highlights some of the political battles being fought over e-cigarettes. In England we view e-cigarettes as a solution to many of the health problems associated with cigarettes. In the USA e-cigarettes are viewed as being bad as cigarettes and simply another way to get the next generation addicted to nicotine. Who will win out England or the USA in terms of health policy and attitudes to e-cigarettes? In my role as a neurologist looking after individual patients with MS I have a responsibility to advise and help individual patients stop smoking; it is part of our the holistic approach management of MS. It is also part of our brain health initiative. If e-cigarettes help achieve that aim at an individual patient level then I am a big supporter of England’s policy and hope it wins out over US policy. What do you think?”

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