Some of the most important conclusions in epidemiologic research have come not from large case-control or cohort studies or clinical trials, but from case studies or case series, or as Dr. Frieden would say, "anecdotes."

Interestingly, it is also possible that electronic cigarettes could have exactly the opposite effect. It is possible that some youths who might have initiated smoking will instead try electronic cigarettes. Further, it is plausible that after using electronic cigarettes, youth may be much less likely to progress to cigarette smoking because compared to the taste and sensation of vaping, the experience of cigarette smoking will not be appealing.

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