Are e-cigarettes safe? Will they help me to quit smoking? Will they harm my kids or encourage them to smoke? These are important questions.
And because e-cigarettes have become popular so fast, from being virtually unheard of to 2.6million British users in under ten years, we need to answer them.
Public Health England recently published an independent review bringing together the most up-to-date scientific data on e-cigarettes and it made some important points:
E-cigarette use carries a fraction of the risk of smoking tobacco
Back in 1976 Professor Michael Russell wrote: "People smoke for nicotine but they die from the tar" and this remains true today.
E-cigarettes work by heating and vapourising a solution that usually contains nicotine, pro-pylene glycol and/or glycerine, and flavourings. Nicotine by itself is relatively harmless, especially when compared to tobacco, and has been used by many thousands of people over many years in the form of nicotine replacement products such as patches and gum.
As well as nicotine, e-cigarette liquid and vapour can contain some toxic substances. But reassuringly the current evidence shows these are at far lower levels than those found in tobacco smoke.
The current best estimate, based on peer-reviewed research, is that e-cigarettes are around 95% less harmful than smoking. This is not to say they are completely risk free and no one would want non-smokers to start using them: but for smokers wanting to quit we have more and more evidence from the UK that e-cigarettes provide another option to help them quit for good.
There's confusion around whether e-cigarettes are safer than smoking
It's worrying that nearly half the population don't realise that e-cigarettes are safer than smoking. In fact, one in five people in Great Britain thought they were at least as harmful as tobacco.
This unjustified fear may mean that some smokers who might have tried to quit with the help of e-cigarettes have carried on smoking instead - causing far greater harm to their health as well as harm to those around them.
E-cigarettes are still relatively new products and no one is saying they are completely risk free. Some flavourings and constituents in e-cigarettes may present a risk over the long term and it is exactly for this reason that we will keep a close eye on the evidence as it emerges. However based on what we know now, there is no doubt that when compared to smoking tobacco, they are a less harmful alternative, and can help smokers finding it hard to quit.
There's no evidence that e-cigarette vapour harms others
Breathing in someone else's tobacco smoke is seriously harmful. It has been linked to significant health problems, especially for children. This is why there is now legislation in England that has banned smoking in enclosed public places and more recently in cars where anyone under the age of 18 is present. We will continue to run campaigns to reduce smoking in homes, especially where children are present.
By contrast, the vapour in e-cigarettes does release very low levels of nicotine into the air, but there is no evidence that this harms people close by.
E-cigarettes help people quit smoking
Quitting smoking is the best thing anyone can do for their health but it's not easy. E-cigarettes are now the most popular quitting tool used in England and evidence has shown they can have similar or better results than nicotine replacement therapies such as patches or gum.
In fact, combining e-cigarettes with expert support from local stop smoking services has shown some of the highest quitting success rates.
E-cigarettes are not acting as a route into smoking
Currently there are nearly eight million adult smokers in England and around 2.6 million e-cigarette users in Britain. Of these, 1.1 million have quit smoking tobacco completely and the rest are still smoking alongside their e-cigarette use, many as part of their attempt to quit smoking.
While e-cigarette use has increased in England, smoking rates have continued to decline among both adults and young people.
Experimentation with e-cigarettes has increased among young people in the UK, 1 in 10 report ever trying these products; however, regular use is rare and is almost completely limited to current or ex-smokers.
This is definitely an area we need to continue monitoring, but this month it became an offence in England and Wales to sell e-cigarettes to anyone under 18 or for an adult to buy e-cigarettes for them. And next year we will see further regulations under the EU Tobacco Products Directive, being introduced to the UK from May 2016.
We will continue to update our recommendations based on the emerging evidence, actively monitor any use by non-smokers and children, and support studying the long term effects. So far the evidence shows that e-cigarettes are far less harmful than smoking and can be effective in helping smokers to quit. The important fact remains that the best thing a smoker can do is quit now, completely and for good.
Follow Professor Kevin Fenton on Twitter: www.twitter.com/ProfKevinFenton