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Controversies

Topics where the published evidence genuinely conflicts, is contested, or remains insufficient. This section presents positions as they are actually held — by named guidelines and studies — without taking sides. Controversies are not manufactured: each topic here has real divergence in the literature or among major guideline bodies.

Current topics

  1. E-cigarettes for smoking cessation — Cochrane finds high-certainty evidence they help people quit; WHO and USPSTF decline to recommend them; NICE explicitly allows offering them. Long-term safety unknown.
  2. Gradual reduction vs abrupt quitting — the Cochrane evidence says supported gradual and abrupt quitting produce similar quit rates; community experience strongly favors cold turkey; the public debate persists.
  3. Dual use (smoking + vaping) — is it a bridge to quitting or a trap that sustains smoking?
  4. Medication comparisons — varenicline vs cytisine vs NRT combinations: what the network meta-analyses actually say.

Reading rules for this section

  • Every position is attributed and dated.
  • "Evidence supporting" and "evidence against / limitations" are listed separately.
  • Where guidelines disagree, the disagreement is stated flatly — the platform does not arbitrate.
  • This is not a list of "both sides" of settled questions. Settled questions (e.g., whether smoking causes cancer) are not controversies.