The beauty of a randomized study is that it can equalize the levels of smoking addiction, reasons for wanting to quit, and motivation to quit across groups. In addition, it equalizes other confounders, including unknown confounders which could affect the study results. There is no way for a survey study to accomplish this. Thus, to simply throw out the RCT is quite unscientific, in my opinion. It throws out one of the most valid pieces of evidence that is necessary to make an informed judgment about the effect of these products: the differences in effectiveness of the products under conditions in which confounding cannot throw off the results.

Instead, the federal government has helped protect the tobacco market by making this unscientific statement for them.

The restriction is inappropriate because it prohibits companies from simply telling consumers the truth about the relative safety of their products. Arguably, this is the single most important piece of information that every consumer needs to know. Keeping consumers in the dark about the relative safety of electronic cigarettes vs. tobacco cigarettes does not serve any public health interest. In fact, it does just the opposite.

The study concludes that "e-cigarette use is aggravating rather than ameliorating the tobacco epidemic among youths."

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