The authors of a related editorial consider the findings of this research to have the following major public health implications:
· Only complete cessation is protective and should be emphasised by all prevention measures and policies.
· Passive smoking is essentially another form of low dose smoking that carries a substantial cardiovascular risk.
· New tobacco products (including e-cigarettes) may carry substantial risk for heart disease and stroke. Although e-cigarettes deliver reduced levels of carcinogens, they still expose users to high levels of ultra-fine particles and other toxins that may markedly increase cardiovascular risk. In their opinion regulatory approval of these products should be withheld; they say “We cannot afford to wait several more decades to document the illness, disability, and deaths caused by new recreational tobacco and nicotine products.”
· E-cigarettes should not be promoted for “harm reduction” on the grounds that they lead people to smoke fewer cigarettes, because modest reductions in cigarette consumption are unlikely to have meaningful health benefits and dual use of cigarettes and e-cigarettes may expose smokers to increased total risks.