This month marks the 50th anniversary of the first stone cast against the Goliathesque tobacco industry. 50 years ago the groundbreaking report Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service was published.

For decades, people had been smoking, either oblivious or overlooking the harmful effects of cigarettes. Whenever concerns were raised by medical experts or governments, they were quickly silenced by the tobacco industry on the basis that there was no proof that smoking was a killer.

The report was an explosive document; using the best epidemiological data and robust, irrefutable scientific evidence, it provided crystal clear proof that cigarette smoking was directly causative of lung disease including cancer, cardiovascular disease, pregnancy complications and foetal harm and increased mortality.

Never before had the tobacco industry been so starkly accused of killing with arguments that could not be disputed. It was the first call to arms against cigarettes and it was the first of many.

Over time, cigarette advertising has been banned, smoking in public areas has been rendered illegal and cigarette taxes have gone up. As a result smoking has dropped along with smoking- related deaths. The anti- smoking campaign is one of the most successful public health projects ever undertaken. However, we can’t rest on our laurels. Despite the reduction in smoking, 6 million people worldwide still die every year from cigarette- related deaths. The war is far from over.

When you’re not winning and you’re desperate,  look for new weapons. Enter the electronic cigarette, the new age high-tech solution to our smoking problem.

Electronic cigarettes or e-cigarettes, depending on how trendy you are, are battery-powered electronic devices that more or less look and feel like cigarettes and simulate smoking. They contain a liquid that vapourises when heated. That liquid can sometimes contain nicotine.

E-cigarettes appeared about 10 years ago in the States and in Europe. They were designed as a safer alternative to cigarettes and the ones containing nicotine could potentially be used to help addicted smokers quit in the same way nicotine patches are used.

It’s a relatively lucrative business, fetching about 650 million dollars last year and profits are projected to reach 1.7 billion dollars this year. There’s big money in addiction, such is the sad truth of the matter.

Of course, there are issues with e-cigarettes. An electronic device that simulates smoking? Seriously?

The main problem with e-cigarettes is that they normalize smoking. The e -cigarette is like the McDonald’s salad: it’s marketed as a healthy substitute but in fact it works on a sub-conscious level to tell you that’s it’s ok to go to McDonald’s and even feed your children there because they sell lettuce and apples. At the end of the day, you’ve normalized going to McDonald’s and integrated it into you daily life.

Public health campaigns so far have centered on taking the sheen off cigarettes and setting the record straight. Only a mere 20 years ago cigarettes were so cool that anyone who was even remotely hip or aspiring to be hip who have a fag dangling from their lips. If you were ubercool, you’d blow smoke rings. Legendary British band Oasis sold records in boxes designed to look like Benson & Hedges packets and pictures of the Marlboro Lights cowboys trotting off into gilded sunsets adorned every respectable magazine.

Public health campaigns dismantled the cool image of cigarette smoking. Revolting pictures of rotting teeth and gangrenous feet replaced the nonchalant cowboys and all cigarette ads were banned. Smoking now rarely features in movies and television shows and public areas have been decreed non-smoking zones. Smoking has gone from being the most popular habit in town to being themost marginalizing one.

E-cigarette marketing will renormalize smoking. If there’s money in it, it will be marketed to death, pardon the pun. Give it a few years and a few promising rises on the stock market and suddenly the e-fag will be on billboards and George Clooney will be endorsing it next to his cup of Nespresso. Public health funds cannot financially compete against large corporations or George Clooney.

That being said, the e-cig may still be the lesser of two evils. E-cigarettes contain no tar and are less harmful than traditional cigarettes. Ideally, you would want to eliminate cigarettes altogether but until we achieve that, electronic cigarettes can be used to minimize the harm of smoking.

There are two schools of thought when it comes to problems like this one: You either try and eliminate the problem entirely by focusing on behavioural change, in other words you get smokers to quit indefi nitely or you focus on harm reduction.

The harm reduction principle has been very successful in the prevention of blood borne diseases such as HIV and hepatitis C. Health campaigns that were urging people to stop intravenous drug use or unprotected sex were largely unsuccessful. They were perceived as paternalistic and moralistic and telling an addict to simply come off the drugs is just plain stupid. Ain’t gonna work. Also nobody likes a moralist and nobody will listen to you if you preach. Especially not kids or teenagers, so already you’ve lost a fair proportion of the people you’re trying to protect.

However, the needle exchange program and the distribution of barrier contraception were incredibly effective at minimizing the spread of disease. Although the underlying risk-taking behaviour was not targeted, the death toll plummeted and that was half the battle won. Behavioural change is difficult and takes a long time; Minimising harm while we find a way to beat the addiction is not an unwise strategy.

Of course, we don’t want to get rid of smoking only to fi nd the public spheres inundated by vaping (the cool term for ‘smoking an electronic ciggie’) but let’s put this in perspective: We could refuse to consider ecigarettes because they may create problems in the future, because it’s playing into another big corporation’s money-making hands, but when 6 million people are dying each year despite our bans, taxes and abstinence campaigns, do we really have a choice?

There’s no easy solution to the problem of smoking; we are fighting a multi-faceted problem of addiction, education and above all else, we are fi ghting a multibillion dollar industry that’s keen to hold on to its profits even if it’s claiming 6 million lives.

The approach to smoking needs to be sophisticated and as complex as the problem itself. The medical community believes that the electronic cigarette should be considered. If you already smoke and simply can’t quit, then the e-cig can be a suitable alternative. However, it should be used cautiously; just like the traditional cigarette, there should be restrictions on advertisement and they should not be available to minors.

The electronic cigarette should be used in conjunction with a structured quitting program. Most doctors know how to do this; we’ve been doing it for ages using nicotine patches.

Getting current smokers to quit is only half the battle.The other, and more difficult half is to prevent the non-smokers from taking up the habit. Most smokers have their first cigarette as teenagers and then go on to become lifelong addicts. Cigarette addiction starts before the age of 20 as the adolescent brain is more vulnerable to the addictive effects of nicotine. Teenagers also crave risk-taking behaviour: call it identity crisis, adolescence or rebellion. Of course it’s by and large stupid but we’ve all been fifteen and stupid, such is life.

Therefore if we want to really eradicate smoking, we need to get to the kids. You can’t change the intelligence or the behaviour of sixteen year- olds but you can put a barrier between their young brains and their poisons. In this country, before the age of 18, you’re considered too immature to vote or drink alcohol. So you can’t decide whether or not you want to smoke a cigarette, even an electronic one.

Selling cigarettes to minors should be illegal. Strictly so, punishable by hefty fines and jail time. A mere three months ago, the State of New York passed the Tobacco 21 bill that forbids the sale of tobacco to people under the age of 21 and already teenage smoking has dropped from 12% to 6%. That’s the good thing about being an adult: you can use the law and end all the Justin Beiber shenanigans for good and society will thank you for it.

Obviously kids have ways to get their hands on all sorts of things; I’ve been a teenager. A teenager who went to public school. So I know. There are more back alleys and ways to adeptly bend the rules than there are annoying student council members to maintain a semblance of order.

I harbour no delusions that every little corner shop will be requesting identifi cation every time a kid tries to buy a pack of cigarettes; it is after all business and business cares very little about the health of children but I’m hoping that law enforcement will be as strict with cigarettes as it is with illegal parking tickets.

In life, there are very few battles worth fi ghting for and this is one of them. We have the technology, we have the strategies and I hope that we have the spirit to soldier on. Wars, like this one, may be fought with weapons but ultimately they are won by men.