The point is that there was no way for the cigarette companies to comply with the law, other than to change the banned descriptors to a new term. And no matter what term they chose, consumers would have figured out which brand was which. Moreover, the law did not specify or imply that the companies were prohibited from informing consumers which brand was which.

But that wasn't the intent of Congress, or of the anti-smoking groups which supported the Family Smoking Prevention and Tobacco Control Act. The intent was to gain a political victory by making it look like they were doing something to protect the public's health, when in truth, they weren't actually doing anything to make cigarettes safer. If anything, they were putting obstacles in the way of transforming the tobacco market into one that is safer.

In a salvo of actions, these lawmakers first issued a decrying the use of flavorings in electronic cigarettes and then the FDA's proposed deeming regulations for not imposing a ban on these flavorings.

But what is the clinical meaning of this effect? In order to find that out, one needs to conduct studies with longer-term end points.

Fortunately, there is a simple way to evaluate this hypothesis, at least on a preliminary basis, prior to waiting for the results of longitudinal studies. Enough youth are experimenting with electronic cigarettes, and the increase in youth e-cigarette use has been dramatic and sustained enough, that if the gateway hypothesis were correct, we would be starting to see an increase in smoking prevalence among youth due to the many new smoking initiates that were converted from e-cigarette experimentation to smoking.

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