(See: Grana R, Benowitz N, Glantz SA. E-Cigarettes: A Scientific Review. Circulation 2014; 129: 1972-1986.)

In 2011, a federal court in the USA gave the Food and Drug Administration the permission to regulate e-cigarettes under the same laws as tobacco consumption. This was due to the fact that these devices provide nicotine just like the real thing. In the UK, the government has taken a different stance and according to the NHS, they are to be considered a medical aid to help smokers kick the habit. This will be brought into play in 2016 and until that date it is thought that e-cigarettes will remain in that grey area that allows their sales to be largely unregulated.

Since Dr. Foulds' addiction scale correlates significantly with actual quitting behavior, one would expect that these results would eventually translate into higher rates of complete nicotine cessation in smokers who switch to electronic cigarettes.

Sadly, there is more to the story of Dr. Luther Terry's reign as Surgeon General and more to the legacy of his having served this critical role as leader of the Public Health Service.

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