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Aim: To explore tobacco profit margins and sales among small retailers in England. Methods: Interviews with managers/owners of 62 small retail shops that sold tobacco in disadvantaged areas of Newcastle and London, England. The interviews included questions about tobacco sales and profit margins, and interest in reducing reliance on tobacco sales. Results: The majority of retailers (89%) reported low overall profit margins on tobacco sales (< 6%). The most common response was a profit margin of 4–6%,with some reporting lower margins for price-marked packs of cigarettes (1–6%) and higher margins for non-price marked or premium brands (7% to over 10%). A few mentioned higher profit margins for e-cigarettes. Despite this, most thought tobacco sales were important (90%), and attributed this reliance to footfall (81%), i.e., customers purchasing tobacco also purchasing other products. 42% of retailers expressed interest in reducing their reliance on tobacco sales. Conclusions: Small retailers report low tobacco profit margins, but high reliance on tobacco sales because of footfall. Retailer interest in reducing reliance on tobacco sales warrants further research into opportunities for disinvestment. Additionally, retailers’ belief that they are reliant on tobacco sales because of footfall should be further investigated.

McKee and Capewell recently criticised Public Health England’s position on e-cigarettes (ECs)1 and our underlying report2 in the Lancet ,3 the media,4 and now The BMJ .5 Their statement “directors of public health and the wider community desperately need advice on EC that is evidence based and free from any suspicion of influence by vested interests”5 is offensive. We have an extensive track record of research dedicated to understanding smoking behaviour and population and individual approaches to help smokers stop and prevent uptake of smoking; we have published hundreds of primary research articles on smoking, nicotine, and ECs; and we have years of clinical experience in smoking cessation. We have never taken any tobacco or EC industry funds. By contrast, McKee and Capewell are not experts in this field—they have carried out no nicotine dependence, smoking cessation, or EC …

The Lancet Editorial criticises our Public Health England commissioned evidence update report on the basis of perceived flaws in one of the 185 references we used, ignoring the rest of our 111 page document, which addresses population effects of e-cigarette use, regulations, attitudes as well as concerns over its safety. The Editorial focuses on the estimate of risk reduction and protests strongly against the media reassuring smokers that switching to e-cigarettes provides substantial health benefits, but it provides no data to counter our estimate, nor any reason as to why The Lancet believes that the message smokers can benefit from switching to vaping is an undesirable one. The estimate that e-cigarette use is around 95% less harmful than smoking is based on the facts that: first, cigarette smoke constituents that harm health are either absent in e-cigarette vapour or, if present, are mostly at levels much below 5% of smoking doses; and second, the main chemicals present in e-cigarettes only have not been associated with any serious risk. Our review highlighted how smokers are currently misinformed about these relative risks. We would encourage people to read our full report before criticising it. Current evidence indicates that smokers who switch from smoking to e-cigarettes reduce the risks to their health dramatically. We believe this needs to be communicated and that undermining this message will keep smokers smoking and dying as a result.