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These data all but destroy the gateway hypothesis. They demonstrate that at the current time, the evidence simply does not support the assertion that the proliferation of e-cigarette use among youth is leading to increased smoking initiation. Electronic cigarettes are not leading to a lifetime addiction to cigarette smoking among our nation's youth.

In order to draw the conclusion that Dr. Glantz drew in his comment, one would have to completely ignore this study. Obviously, Dr. Glantz has done exactly that. He has based his comment on one narrow study and ignored the rest of the literature.

This assertion is based on a new study which found that electronic cigarette use, like smoking, results in reduced levels of exhaled nitric oxide. As Dr. Glantz writes:

The truth is that the ad was created independently as part of a viral video contest. Apparently, blu did not do anything to dissociate itself from the ad. However, the ad was produced in 2010, two years before it was purchased by Lorillard. Thus, Lorillard had nothing to do with the ad.

Even in light of a lack of official health studies, the AHA, as well as many other health care professionals can’t deny the use of e-cigarettes as a harm reducer. The policy from the AHA states: “E-cigarettes either do not contain or have lower levels of several tobacco-derived harmful and potentially harmful constituents compared with cigarettes and smokeless tobacco. In comparison with NRTs, [Nicotine replacement treatments] e-cigarette use has increased at an unprecedented rate, which presents an opportunity for harm reduction if smokers use them as substitutes for cigarettes.”


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