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The rest of the story is that in yet another area of tobacco control science, the Surgeon General's report is providing a biased view of the scientific evidence.

Later in the article, the FDA reiterates its position: "while the inhaled compounds associated with e-cigarettes may be fewer and less toxic than those from traditional cigarettes, data to establish whether e-cigarette use as a whole is less harmful to the individual user than traditional cigarettes are not conclusive."

Peter Hajek, director of the Tobacco Dependence Research Unit at Queen Mary, University of London, also this critical flaw in the study: ""The authors followed up smokers who tried e-cigarettes but did not stop smoking, and excluded smokers who tried e-cigarettes and stopped smoking," he said. "Like smokers who fail with any method, these were highly dependent smokers who found quitting difficult. The authors concluded that e-cigarette (use) was not helpful, but that would be true for any treatment however effective if only treatment failures were evaluated."

Some of the researchers and advocates who opposed our crowdfunding campaign to raise money for a randomized behavioral study of the effects of electronic cigarettes on smoking behavior argued that randomized clinical trials (RCTs) are simply not appropriate to study e-cigarettes because they cannot simulate the real-life situation, where smokers have many choices of different types of products, can engage with social networks, and can experiment over time, change products, advance from one type of product to another, etc.


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