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completely from tobacco to e-cigarettes achieves much the same in health terms as does <br />quitting smoking and all nicotine use completely. Furthermore… risks associated with <br />passive exposure to e-cigarette vapour are far less than those associated with passive <br />exposure to tobacco smoke.’ <br />If influential health officials were to make these points repeatedly, public sentiment towards <br />e-cigs would shift quickly. And this could be done at the same time as strengthening anti- <br />smoking measures. <br />We should praise ‘good’ e-cig companies who commit to safety, to avoiding youth <br />marketing, and to making smoking obsolete. They need to be explicit about their long-term <br />plans. Are they seriously committed to harm reduction, or introducing new products simply <br />to delay progress and confuse policymakers, as many in public health believe? <br />From my meetings with major tobacco companies, it’s clear that they are hedging their bets. <br />Some of them have indicated, in private, a long-term goal of moving out of manufacturing <br />harmful tobacco products — but these statements are not enough to inspire trust. Tobacco <br />companies’ intention to change must be stated publicly and backed by action. <br />Other market sectors need to adapt to the reality of e-cigs as a force for good. Retailers <br />should voluntarily withdraw cigarettes from stores, or at least reduce their prominence, in <br />favour of e-cigs and NRTs. CVS Health has yet to offer e-cigs, despite the fact that they work <br />better than pharmaceutical products. Life insurers still treat e-cig users as regular smokers <br />when they calculate premiums. This is short-sighted and misses a golden opportunity to <br />spell out the benefits of quitting smoking and the positive impact of switching to e-cigs on <br />people’s longevity. <br />At the moment, it’s estimated that there will be a billion tobacco-related deaths before 2100. <br />That is a dreadful prospect. E-cigs and other nicotine-delivery devices such as vaping pipes <br />offer us the chance to reduce that total. All of us involved in tobacco control need to keep <br />that prize in mind as we redouble efforts to make up for 50 years of ignoring the simple <br />reality that smoking kills and nicotine does not. <br />A toxic legacy