To be completely honest, Trueba et al. actually found that not only did taking an exam affect nitric oxide levels, but it also produced decreases in lung function measured by spirometry. This is something that has not been observed for electronic cigarettes.

Because this research was funded by the federal government (by the Army Research Office, to Cornell), it is subject to the human subjects research requirements. In addition, the involvement of two researchers at academic (federally-funded) institutions requires that the research be approved by an Institutional Review Board. Apparently, the research was approved by an academic IRB, a decision which I publicly question, for the above reasons.

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."

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