There are some specific problems with survey studies that could lead to an overestimation of the benefits of electronic cigarettes. One major problem is that a survey study of the use of advanced vapor products would result in a severe bias towards finding a high level of effectiveness of these products. The reason? By the time smokers advance to use products like open-ended systems, they have already experienced success, fulfillment, and enjoyment with vaping. In other words, limiting the sample to users of advanced vapor products filters out the majority of e-cigarette users, who do not experience great success and therefore don't go on to the more advanced products.

The report issued by these lawmakers calls for a ban on flavors in e-cigarettes.

The Rest of the Story

The Centers for Disease Control and Prevention (CDC) is telling the public that electronic cigarettes are a gateway to youth smoking. The CDC has alarmed the public about a concerning doubling of the use of electronic cigarettes by teenagers from 2011 to 2012. Although I pointed out that most of this use occurred among smokers, the CDC nevertheless concluded that electronic cigarettes are leading to increased smoking rates among youth.

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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