Several British health groups are proposing that e-cigarettes be recommended for smoking cessation and harm reduction.

Public Health England (PHE), a group made up of health specialists from more than 70 organizations in the UK, released an independent review of the evidence that evaluated e-cigarettes and health. The report from summer 2015 concluded that e-cigarettes were around 95% less harmful than combustible cigarettes and that there is, as yet, no evidence to suggest they are gateway products to smoking.

Epidemiologist Sharon Green, MPH, and colleagues from Columbia University in New York City questioned whether the PHE report, and the acceptance of its conclusions by other public health groups in the UK, will ultimately reframe the public policy debate about e-cigarettes in the US.

“Strikingly, the [PHE] report underscored e-cigarettes’ potential to address the challenges of health inequalities, a central mission of PHE, stating that these devices ‘potentially offer a wide reach, low-cost intervention to reduce smoking and improve health in these more deprived groups in society where smoking is elevated,'” they wrote in a perspective in the New England Journal of Medicine.

Green’s group argued that the difference in how health officials in the U.K and the U.S. view e-cigarettes reflects a longstanding difference in their perspective on public health — policymakers across the pond focus on reducing harm, while those in the states favor an approach that minimizes risk through prohibition and abstinence.

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