However, from a public health perspective, the relevant question is not what results one would obtain if smokers were forced to use a particular strategy, but what results are obtained when smokers make the choice to use a particular strategy. This is why Stan Glantz's approach is inappropriate.

This study confirms that in the UK, despite substantial experimentation with e-cigarettes by youth, this experimentation does not appear to be leading to regular e-cigarette use by a large proportion of youth, and those who are regular users are overwhelmingly youth who are already smokers or who smoked in the past.

This demonstrates just how contentious harm reduction debates are, especially in tobacco control. Both sides are acting on zealous idealism, with science playing very little role.

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