We write out of continuing concern about the call for a complete ban on e-cigarettes, heated tobacco products and other reduced risk tobacco product sales and possession.

The justifications for this ban – including that both combustible cigarettes and reduced risk products are harmful, and that people should quit using other “proven effective” methods – ignores the potential for reduced risk products to help people who smoke to move away from the most hazardous product, cigarettes.

In fact, it matters a great deal how harmful a product is; based on what we already know, there is no credible doubt that smoke-free products are much less harmful than cigarettes. We have also seen recent trial results suggesting that e-cigarettes are twice as effective as nicotine replacement therapy, and there is data showing that these products are more effective than nicotine replacement therapies or prescription medications.

Given that less than 10 per cent of quit attempts using traditional methods are successful, reduced risk products can and do provide a safer alternative to combustible cigarettes for current and future smokers.

In Hong Kong, it is among younger smokers (20-39) that e-cigarette use is increasing, with a correlated decrease in combustible use. It is likely that e-cigarettes are replacing smoking in younger populations that currently smoke.

We hope all those concerned with public health and personal welfare will reconsider the case for banning e-cigarettes and other low-risk alternatives to smoking, and adopt risk-proportionate regulation, rather than prohibition.

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