According to the deeming regulations, electronic cigarettes cannot inform consumers that the electronic cigarette "presents a lower risk of tobacco-related disease or is less harmful than one or more other commercially marketed tobacco products" (which includes cigarettes). In other words, the marketing of electronic cigarettes will need to be based on the false pretense that e-cigarettes are not intended as a safer alternative to smoking.

As electronic cigarettes become more mainstream, physicians will be called on more and more to discuss the safety and effectiveness of these types of devices/products. It is extremely crucial that the FDA take in all the evidence on electronic cigarettes and deliver a clear and substantial review for not only physicians, but the general public as well in regards to them being a possible safer tobacco substitute. Most physicians seem to a similar thought process pertaining to the overall recommendations of using an e-cig as a tobacco eliminating solution – primarily giving their patients as much info as possible – good and bad – and letting them decide on their own.

First, he cites the JAMA Pediatrics article in which Glantz and Dutra conclude that electronic cigarettes are exaggerating, rather than ameliorating smoking among youth. Clive writes: "somehow you have managed to position this study as showing there is a gateway from e-cigarette use to smoking. NOTHING in the study or the underlying data suggests this. You would need information on how smoking, e-cigarette use and abstinence evolved over time to test these hypotheses, but your study does not have that."

In other words, despite acknowledging that they cannot tell from their study whether e-cigarette use precedes smoking or whether smoking precedes e-cigarette use, they nonetheless draw the conclusion that e-cigarette use precedes smoking.

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