Nevertheless, this does not stop the authors from drawing a conclusion. They conclude, despite their acknowledged inability to draw such a conclusion, that: "e-cigarette use is aggravating rather than ameliorating the tobacco epidemic among youths."

On the site, ANR makes the following claim: "A recent survey conducted by Harris Decima, a Harris Interactive company, for Mistic e- cigarettes purports to document public support for use of e-cigarettes in in a variety of places, including airplanes, workplaces, sporting events, restaurants and bars, and more. But the survey should be looked at skeptically, inasmuch as, historically, research funded by the tobacco industry tends to yield results favorable to the industry's position. One only needs to refer to the landmark Department of Justice case against the tobacco companies to know their history of disseminating misinformation designed to protect industry profits."

Even in light of a lack of official health studies, the AHA, as well as many other health care professionals can’t deny the use of e-cigarettes as a harm reducer. The policy from the AHA states: “E-cigarettes either do not contain or have lower levels of several tobacco-derived harmful and potentially harmful constituents compared with cigarettes and smokeless tobacco. In comparison with NRTs, [Nicotine replacement treatments] e-cigarette use has increased at an unprecedented rate, which presents an opportunity for harm reduction if smokers use them as substitutes for cigarettes.”

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