Anne Arundel Medical Center in Annapolis wants to encourage smokers to quit, but only in the way the hospital says they should quit. Specifically, smokers who successfully quit smoking using electronic cigarettes will not be eligible for employment if they are continuing to use e-cigarettes to stay smoke-free. Moreover, smokers who are currently attempting to quit using e-cigarettes will not be eligible for employment, no matter how successful they might be in quitting or cutting down using these products.

The study finds that e-cigarette use is associated with smoking status. In addition, e-cigarette use is associated with heavier smoking and with fewer periods of smoking abstinence.

The authors admit this in the paper. They write: "This is a cross-sectional study, which only allows us to identify associations, not causal relationships."

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