The problem is that in this cross-sectional study, there is no way to determine the direction of the observed relationship.

If we accept that authors' word - that there is no way from this study to exclude the possibility that youths are initiating smoking with conventional cigarettes and then moving on to e-cigarettes - then it follows that these authors are being dishonest in telling the public that the study shows that:

The methods of the study were as follows: "Individuals were recruited at e-cigarette retail locations in a large metropolitan city in the midwestern portion of the United States in July 2013. A total of 159 participants completed a brief 29-item self-report measure that assessed behaviors and perceptions of use."

In a move that could not be more favorable to the cigarette industry in Daly City, California, the city's mayor that sell electronic cigarettes which are being used by many Daly City smokers to quit smoking or cut down substantially on the amount they smoke, while .

The rest of the story is that none of these studies examined quit rates among smokers who were trying to quit using e-cigarettes. None of these studies were in fact designed to examine the role of e-cigarettes in smoking cessation in the first place.

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