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Medicalisation, smoking and e-cigarettes: evidence and implications
  1. Kylie Morphett1,2,
  2. Adrian Carter3,
  3. Wayne Hall4,5,
  4. Coral Gartner1,4
  1. 1 University of Queensland School of Public Health, Herston, Queensland, Australia
  2. 2 University of Queensland School of Medicine, Royal Brisbane and Women's Hospital Site, Herston, Queensland, Australia
  3. 3 School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Victoria, Australia
  4. 4 University of Queensland Centre for Clinical Research, Royal Brisbane and Women's Hospital Site, Herston, Queensland, Australia
  5. 5 University of Queensland Centre for Youth Substance Abuse, Floor K, Mental Health Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
  1. Correspondence to Kylie Morphett, University of Queensland School of Public Health, Public Health Building, Corner of Wyndham Street and Herston Road, Herston, QLD 4029, Australia; k.morphett{at}


There is debate in the tobacco control literature about the value of a medical model in reducing smoking-related harm. The variety of medical treatments for smoking cessation has increased, health professionals are encouraged to use them to assist smoking cessation and tobacco dependence is being described as a ‘chronic disease’. Some critics suggest that the medicalisation of smoking undermines the tobacco industry's responsibility for the harms of smoking. Others worry that it will lead smokers to deny personal responsibility for cessation, create beliefs in ‘magic bullets’ for smoking cessation, or erode smokers' confidence in their ability to quit. We argue that the medicalisation of smoking will have limited impact due to the emphasis on population-based interventions in tobacco control, the ambiguous place of nicotine among other drugs and the modest efficacy of current pharmacotherapies. These factors, as well as lay understandings of smoking that emphasise willpower, personal choice and responsibility, have contributed to the limited success of medical approaches to smoking cessation. While the rapid uptake of e-cigarettes in some countries has provided an option for those who reject medical treatments for smoking cessation, current regulatory developments could limit the potential of e-cigarettes to provide non-therapeutic nicotine for those who currently smoke tobacco.

  • Addiction
  • Cessation
  • Electronic nicotine delivery devices
  • Nicotine

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  • Contributors KM was responsible for the research and first draft of the manuscript. CG, WH and AC all contributed to the development of ideas, and to the writing of subsequent versions of the manuscript.

  • Funding This work was funded by an Australian Research Council Discovery Grant (grant ID: DP120100732) awarded to WH. KM was supported by an Australian Postgraduate Award and a UQ Advantage top-up scholarship. WH was supported by a National Health and Medical Research Council Australia Fellowship (grant ID: 569738). CG and AC were supported by National Health and Medical Research Council Fellowships.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.