Furthermore, later in the paper they reinforce this point more specifically, writing: "the cross-sectional nature of our study does not allow us to identify whether most youths are initiating smoking with conventional cigarettes and then moving on to (usually dual use of) e-cigarettes or vice versa...".

Yesterday, I was informed by one of the contributing authors to the 2014 Surgeon General's report that each of the authors and reviewers of the report was required to complete conflict of interest disclosure forms. This makes the problem even more serious than it initially appeared. It now seems that this is not merely a matter of the CDC not knowing about, or failing to inquire about the conflicts of interest of report authors. Instead, this is now a matter of the CDC hiding, or covering up, these conflicts of interest, which are not revealed to the public anywhere in the report or on the report's web site.

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