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E-cigarettes should be regulated

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They pose many risks for tobacco control and health, and any possible benefits are few and uncertain

As reported in this issue of the MJA,1 Australia, with the world’s lowest rates of smoking among adults2 and adolescents,3 is seeing nascent, modest growth in e-cigarette use, despite having some of the strongest restrictions on their marketing and sales. Manufacturers, now including all major tobacco corporations, have spent large sums publicising their brands, using tactics that have promoted cigarettes so successfully, but boosted by the added reach of the internet. They are ahead of the regulatory curve, adopting imagery, messages and tactics prohibited in cigarette promotions, such as the sponsorship of youth events.4 They have spiced their products with a bewildering array of flavourings that in many countries would be illegal in cigarettes, and have garnered vocal support from those who see any restriction on the use of e-cigarettes by governments as a threat to individual freedom. Some aspects of these developments are, however, surprising.

The first is that, despite intensive marketing, the use of e-cigarettes in some countries now seems to be plateauing,5 suggesting that their much vaunted appeal for smokers and the talk of mass migration to…