The letter picks up on many of the precise points that I have been arguing during the past few weeks: ; ; .

The rest of the story is that regulatory power has corrupted the science at the FDA. The FDA has been infected with the virus that causes an agency to regulate for regulation's sake. The agency has created a huge bureaucracy which is accomplishing absolutely nothing to protect the public's health. It is a profound waste of time and resources. The FDA would be better off using the money being spent on substantial equivalence applications on an aggressive, anti-smoking television campaign that would actually do something to protect the public's health.

In my opinion, the fact that there are significant conflicts of interest that should have been disclosed is undeniable. Moreover, it is undeniable that these conflicts are relevant to the subject matter of the paper. The article makes the bold and I believe incorrect statement that treatment with drugs is the "standard of care" for smoking cessation. In fact, I believe that there are many methods that physicians appropriate use to promote smoking cessation in their patients, and medication is only one of these methods. Many physicians recommend other approaches, including counseling, hyponosis, 12-step programs, and cold turkey quitting.

I am not going to comment on taste or throat hit as this isn’t the topic of discussion and thus I’ll also leave the kanger and name of the E-Juice anonymous as well. My biggest complaint about the E-Juice was the lack of labeling of how much caffeine was in the bottle. The only thing the bottle said was “with caffeine.” Like nicotine, caffeine is a stimulant and in large doses could potentially be fatal. Knowing how much is in the bottle is crucial for users.

They write: "What’s even more troubling is that these products serve as a gateway to traditional tobacco products. A recent JAMA Pediatrics study found that middle and high-school students who used e-cigarettes were more likely to smoke traditional cigarettes and less likely to quit smoking." In support of this statement, they cite the Glantz and Dutra cross-sectional study of e-cigarette use and smoking among youth.

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