If this study leads some smokers to smoke inside because they believe the researchers, who say that thirdhand smoke is no less harmful than secondhand smoke, then this could lead to serious public health harm to children.

It is worth noting that the conclusions which Dr. Glantz is disseminating are destructive because they undermine decades of public education about the severe hazards of smoking. If the public thinks that smoking is only as risky as vaping, then it is likely that many smokers will decide to continue smoking rather than quitting using electronic cigarettes. And many ex-smokers who have quit with electronic cigarettes may return to smoking, thinking that they might as well since they are not getting any definite health benefit from having made the switch.

Fortunately, there is a simple way to evaluate this hypothesis, at least on a preliminary basis, prior to waiting for the results of longitudinal studies. Enough youth are experimenting with electronic cigarettes, and the increase in youth e-cigarette use has been dramatic and sustained enough, that if the gateway hypothesis were correct, we would be starting to see an increase in smoking prevalence among youth due to the many new smoking initiates that were converted from e-cigarette experimentation to smoking.

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