What about E-cigarettes?

T his issue of Pediatric Annals includes a series of fascinating pe-diatric cases that are very educational. As noted by Stan L. Block, MD, FAAP, this is his last " Healthy Baby " column—at least for a while. Stan, the self-styled small town " country doctor, " has done a fabulous job of writing a column each month on a topic relevant to general pediatrics. We are greatly indebted to his outstanding efforts and his eagerness to share his wisdom from his long service in the trenches. Thank you, Stan! Job well done! Pediatrics lost a giant recently. Dr. Mike Marcy, who worked at Kaiser Permanente in Southern California for many decades as an outstanding Infectious Diseases Clinician and Teacher, died recently at age 78 years. Mike was a most worthy recipient of the Ameri-can Academy of Pediatrics Section on Infectious Disease's Lifetime Achievement Award for Education. He was also a great friend. This loss in Pediatrics is great, and I send condolences to his family. I wrote about " e-cigarettes " about 1 year ago. Electronic cigarettes provide vaporized nicotine that is addictive, but they lack combustible tobacco, which causes cancer and kills many thousands annually. Thus, many believe that e-cigarettes are relatively preferable to smoking cigarettes. Of course, this topic is important to those of us who take care of adolescents for whom avoidance of tobacco is a key item for discussion. In an interesting column in The New York Times, 1 columnist Joe Nocera summarized what he learned recently at the " 2nd Annual E-Cig Conference. " The reasons aren't precisely clear, but e-cigs have not been welcomed by the tobacco control community, probably because of lingering uncertainty about their safety. However, some traditional proponents of tobacco control are beginning to view e-cigs as useful in helping smokers to quit their habit. Kenneth Warner of the University of Michigan and Harold Pollack of the University of Chicago recently published " The Nicotine Fix " on The At-lantic's website. 2 They consider there to be three groups of individuals in the modern tobacco control world: the Traditionalists , the Harm Reductionists, and the End-gamers. The Traditionalists argue that we need to keep doing what has worked so far, with warning labels on packages, public service ads, and legislation for increasing smoking restrictions. The Harm Reductionists favor reducing the dangers involved rather than trying to eliminate a risky behavior; …