Conflicts within public health aren’t new, of course—consider the lingering controversies over saturated fat or mammograms. But it is surprising to see this dispute play out in a community where previously the only disagreement about cigarettes had been over which regulations were needed and how quickly. “It has split tobacco researchers into two groups: those for and against,” notes Vardavas. “It’s horrific to watch—it’s almost like a civil war.”
Viswanath agrees, adding: “There are clearly two sides, or three sides if you include those like me in the middle trying to figure out what the heck we are talking about.”
Yet other Harvard Chan researchers sense that over the past year, the public health community may be moving toward a tentative agreement on the potential benefits of e-cigarettes. According to Vaughan Rees, interim director of the School’s Center for Global Tobacco Control and an expert on substance abuse and dependence, the field is coalescing around the idea that, if regulated properly, e-cigs could bolster overall harm reduction by helping smokers quit tobacco cigarettes or helping them smoke less. The trick will be regulation, he adds. “Harm reduction can only work in a regulatory environment that encourages complete switching among current smokers or tobacco users, and discourages use among adolescents.”