Closing Keynote: Keeping our eyes on the prize in nicotine and tobacco policy

Public health professionals care about tobacco use because it is so harmful to health. It is our job to discover ways to achieve reduce it to the lowest possible level, ideally zero, in ways that are acceptable to the public and policymakers. In my view it is not our job to be guardians of public morality. Neither is it our job to tell the public what it should think. There are considerable risks attached to confusing moral and health objectives in public health, not the least of which is that if the public see us as preaching to them, they lose trust in us when we make scientifically sound statements about health harms and propose policies and interventions to combat these. Arguably, in discourse about e-cigarettes, moral views about what people should and should not enjoy have led to misleading claims from some highly influential public health professionals and health organisations. We are at yet another crossroad in policy choices about e-cigarettes and public health professionals must be self-reflective and humble in pronouncements about the potential harms and benefits of particular policies – always doing our best to use modern ‘systems thinking’ to estimate the impacts of different policy choices taking into consideration the political and commercial landscape.