The critics’ anxieties are not without merit, but they need to be placed in the context of the good that e-cigarettes do by sparing nicotine-dependent individuals from carcinogenic smoke. Precautionists are unmoved by the harm that comes to smokers who have failed to quit but who cannot take advantage of less dangerous ways of using nicotine. Accordingly, this camp seeks heavy regulatory oversight by the FDA and bans on television advertising and on vaping in public.
The pragmatists, who advance a public-health approach called “tobacco-harm reduction,” support electronic cigarettes because the devices are much less harmful than the considerable harms of combustible cigarettes. Pragmatists are not fixated on whether vaping is completely safe but on whether it is safer for smokers than cigarettes are. They are willing to make policy trade-offs on the basis of cost–benefit analyses. Some pragmatists hope that the FDA will go so far as to deem e-cigarettes outside its regulatory purview altogether — a decision that the agency could theoretically make within the next few weeks or months but almost surely will not. Pragmatists also want states to tax e-cigarettes minimally if at all, to incentivize smokers to switch. Pragmatists do agree with precautionists about e-cigarettes on one point: The devices should not be sold or marketed to children.