"Short term use of e-cigarettes has been shown to increase respiratory resistance and impair lung function, which may result in difficulty breathing."

Here, they find a correlation between e-cigarette use and higher and more sustained levels of smoking. But because this is a cross-sectional study, they cannot determine which came first. In other words, what is the direction of the causal relationship? Does the e-cigarette use precede, and cause, the smoking? Or does the smoking precede, and cause, the e-cigarette use?

What makes the Citizens Medical Center policy particularly ugly is that they justify it by arguing that their patients don't want to see obese people people it doesn't fit with their "mental projection" of a healthcare professional. That is simply disgusting. The same thing could have been said years ago (or maybe today) about certain other groups, such as black health care workers, LGBT workers, or Jewish workers.

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