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In July 2013, a group of 12 experts in decision science, medicine, pharmacology, psychology, public health policy, and toxicology rated the relative harm of 12 nicotine-containing products by using 14 criteria addressing harms to self and others. 1 The group concluded that combustible cigarettes were the most harmful and that electronic nicotine delivery systems (electronic cigarettes or e-cigarettes) were substantially less harmful than combustible cigarettes. These results have been characterized and repeated in the popular media as e-cigarettes are “95% less risky” or “95% less harmful” than combustible cigarettes. However, as the authors noted in a sweeping statement regarding the shortcomings of their own work,“A limitation of this study is the lack of hard evidence for the harms of most products on most of the criteria.” 1 (p224)

Despite this lack of hard evidence, Public Health England and the Royal College of …