Slippery Slopes and Trojan Horses: The Construction of E-Cigarettes as Risky Objects in Public Health Debate

Part of the Health, Technology and Society book series (HTE)


Focusing on debates around the risk/benefits of e-cigarettes within the field of public health, this chapter argues that the for/against sides in these debates construct e-cigarettes as different objects, with implicit assumptions about what these objects ‘are’, how people will respond to them, and their comparability to tobacco cigarettes. Drawing on practice theory approaches, this chapter questions such assumptions, pointing out that objects are ‘made’ through practices and thus cannot be divided from their contexts, with different contexts enacting differing objects. The ‘riskiness’ of objects is therefore relational rather than an inherent quality in technologies themselves. Such debates tell us more about the assumptions embedded within public health itself and are themselves examples of how new technologies create new relations and material effects.



Many thanks to Simon Cohn, Emma Garnett and Conor Farrington for their comments in the development of this chapter.


  1. Abrams, D. B. (2014). Promise and peril of e-cigarettes: Can disruptive technology make cigarettes obsolete? The Journal of the American Medical Association, 311(2), 135–136.CrossRefGoogle Scholar
  2. ASH. (2016). Use of electronic cigarettes (vapourisers) among adults in Great Britain. Action on Smoking on Health (ASH) Fact sheet 33, April 2016. Available online at: Accessed November 7, 2016.
  3. Baudrillard, J. (1994/1981). Simulcra and simulation. Trans. S. F. Glaser. USA: University of Michigan Press.Google Scholar
  4. Beck, U. (1992). Risk society: Towards a new modernity. London: Sage.Google Scholar
  5. Bell, K., Salmon, A., Bowers, M., Bell, J., & McCullough, L. (2010). Smoking, stigma and tobacco ‘denormalization’: Further reflections on the use of stigma as a public health tool. A commentary on Social Science and Medicine’s Stigma, prejudice, discrimination and health special issue (76: 3). Social Science and Medicine, 70, 795–799.CrossRefGoogle Scholar
  6. Bell, K., & Keane, H. (2012). Nicotine control: E-cigarettes, smoking and addiction. International Journal of Drug Addiction, 23, 242–247.Google Scholar
  7. Benjamin, W. (1968/1955). The work of art in the age of mechanical reproduction. In H. Arendt (Ed.), Illuminations (pp. 214–218). London: Fontana.Google Scholar
  8. Bennet, T. (2013). Habit: Time, freedom, governance. Body & Society, 19(2–3), 107–135.CrossRefGoogle Scholar
  9. Benson, P. (2010). Safe cigarettes. Dialectical Anthropology, 34, 49–56.CrossRefGoogle Scholar
  10. Britten, J., & Bogdanovica, I. (2014). Electronic cigarettes. A report commissioned by Public Health England. London: Health and Wellbeing Directorate, Public Health England. Available online at: Accessed January 26, 2016.
  11. Bunton, R., & Coveney, J. (2011). Drugs’ pleasures. Critical Public Health, 21, 9–23.CrossRefGoogle Scholar
  12. Caplan, P. (2000). Introduction. In P. Caplan (Ed.), Risk revisited (pp. 1–28). London: Pluto Press.Google Scholar
  13. Chapman, S. (2013). Should e-cigarettes be as freely available as tobacco? No. British Medical Journal, 346, 3840–3841.CrossRefGoogle Scholar
  14. Chapman, S. (2014). E-cigarettes: Does the new emperor of tobacco harm reduction have any clothes? European Journal of Public Health, 24(4), 535–536.CrossRefGoogle Scholar
  15. Conrad, P. (1992). Medicalization and Social Control. Annual Review of Sociology, 18, 209–232.CrossRefGoogle Scholar
  16. Cooper, A. J. M., Dearnley, K., Williams, K., et al. (2015). Protocol for the Get Moving trial: A randomised controlled trial to assess the effectiveness of minimal contact interventions to promote fitness and physical activity in an occupational health setting. BMC Public Health, 15, 296.CrossRefGoogle Scholar
  17. Coveney, J., & Bunton, R. (2003). In pursuit of the study of pleasure: Implications for health research and practice. Health, 7, 161–179.CrossRefGoogle Scholar
  18. De Andrade, M., Hastings, G., & Angus, K. (2013). Promotion of electronic cigarettes: Tobacco marketing reinvented? British Medical Journal, 347, 15–17.CrossRefGoogle Scholar
  19. Dew, K. (2012). The cult and science of public health. A sociological investigation. New York & Oxford: Berghahn Books.Google Scholar
  20. Ecks, S. (2008). Three propositions for an evidence-based medical anthropology. Journal of the Royal Anthropological Institute (N.S.), S77–S92.Google Scholar
  21. Etter, J. F. (2013). Should e-cigarettes be as freely available as tobacco? Yes. British Medical Journal, 346, 3845–3846.CrossRefGoogle Scholar
  22. Fairchild, A. L., Bayer, R., & Colgrove, J. (2014). The renormalization of smoking? E-cigarettes and the tobacco ‘endgame’. New England Journal of Medicine, 370, 293–295.CrossRefGoogle Scholar
  23. Frazer, J. G. (1890). The golden bough: A study in comparative religion. London: Macmillan.Google Scholar
  24. Giddens, A. (1991). Modernity and self-identity: Self and society in the late modern age. Cambridge: Polity Press.Google Scholar
  25. Hajek, P. (2013). Electronic cigarettes for smoking cessation. Lancet, 382, 1614–1616.CrossRefGoogle Scholar
  26. Hsu, R., Myers, A. E., Ribisl, K. M., et al. (2013). An observational study of retail availability and in-store marketing of e-cigarettes in London: Potential to undermine recent tobacco control gains? British Medical Journal Open, 3, e004085.Google Scholar
  27. Kandel, D. B. (2003). Does marijuana use cause the use of other drugs? Journal of the American Medical Association, 289(4), 482–483.CrossRefGoogle Scholar
  28. Klein, R. (1995). Cigarettes are sublime. Reading: Picador.Google Scholar
  29. Law, J., & Singleton, V. (2005). Object lessons. Organization, 12, 331–355.CrossRefGoogle Scholar
  30. Lynch, R., & Cohn, S. (2015). In the loop: Practices of self-monitoring from accounts by trial participants. Health: An Interdisciplinary Journal for the Social Study of Health Illness and Medicine, 20(5), 523–538.CrossRefGoogle Scholar
  31. Maller, C. J. (2015). Understanding health through social practices: Performance and materiality in everyday life. Sociology of Health & Illness, 37(1), 52–66.CrossRefGoogle Scholar
  32. McKee, M., & Capewell, S. (2015). Electronic cigarettes: We need evidence, not opinions. The Lancet, 386(10000), 1239.CrossRefGoogle Scholar
  33. McNeill, A., Brose, L. S., Calder, R., Hitchman, S. C., Hajek, P., & McRobbie, H. (2015). E-cigarettes: an evidence update. A report commissioned by Public Health England. Crown Copyright.Google Scholar
  34. Mol, A. (2002). The body multiple: Ontology in medical practice. Durham: Duke University Press.CrossRefGoogle Scholar
  35. Pols, J. (2012). Care at a distance: On the closeness of technology. Amsterdam: Amsterdam University Press.CrossRefGoogle Scholar
  36. The Publican’s Morning Advertiser. (2013). ‘Fuller’s bans e-cigarettes from pubs’ by Ellie Bothwell, 27th November 2013. Available online at: Accessed January 31, 2016.
  37. Public Health England. (2015). E-cigarettes: A new foundation for evidence-based policy and practice. PHE publications gateway number: 2015260. Available online at: Accessed January 31, 2016.
  38. Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: Important considerations for public health. American Journal of Public Health, 100, 1019–1028.CrossRefGoogle Scholar
  39. Stimson, G. V. (2014). Public health leadership and electronic cigarette users. European Journal of Public Health, 24(4), 534–535.CrossRefGoogle Scholar
  40. Taussig, M. (1993). Mimesis and alterity: A particular history of the senses. London: Routledge.Google Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  1. 1.London School of Hygiene and Tropical MedicineLondonUK

Personalised recommendations