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...".

Because of the importance of this issue, I have written to the editorial staff of JAMA, urging them to publish a corrective statement, requiring Dr. Fiore to disclose his long and intensive history of conflicts of interest with pharmaceutical companies that manufacture smoking cessation drugs.

"I'm sure this will happen and that is not a good thing, it's quite likely, in my view, many of these young people will then transition to cigarettes themselves."

In 2014, the tobacco companies have changed their behavior and have ceased and desisted from arguing that even major differences between cigarette brands render them different in terms of overall public health risk. In fact, Philip Morris has explicitly the following: "As of today ... there is no cigarette on the market that public health organizations endorse as offering 'reduced risk.' If smokers are concerned about the risks of cigarette smoking, the best thing to do is quit."

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