Based on these most recent data from the UK, it appears that there just is not evidence to support the wild contentions that anti-smoking groups, advocates, and health agencies like the CDC and World Health Organization are disseminating to the public. Contrary to what Stan Glantz is telling the press, there simply is no evidence that the use of electronic cigarettes is undermining smoking cessation or impeding the decline in smoking prevalence. Nor is there evidence that electronic cigarettes are causing nonsmokers or ex-smokers to return to cigarette smoking. Moreover, there is no evidence that dual use is decreasing the motivation of smokers to quit or precluding these smokers from reaping any health benefits.

The answer:

Whether e-cigarette use precedes smoking or smoking precedes e-cigarette use is a critical question, but it is one which needs to be answered through longitudinal research. We need studies that follow the trajectory of teen tobacco/e-cigarette use over time. That is the only way to determine which comes first.

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