If the goal here were to simply protect children and infants from accidentally ingesting nicotine, then Senator Hannon could simply have introduced legislation to require childproof packaging and warning labels on these products. Instead, it appears that the goal is actually to protect the sale of cigarettes in New York by eliminating competition from a rapidly proliferating smoking cessation product that is projected to give tobacco cigarettes a run for their money.

Neither the survey approach or the RCT approach is perfect. Both have major strengths and significant limitations. The best way to proceed is to conduct both types of studies and to synthesize the results across study designs, keeping in mind the methodological strengths and limitations of each individual study. Only by looking at this totality of the evidence can we draw valid scientific conclusions.

In my view, Dr. Fiore's failure to disclose these conflicts suggests that he really does have something to hide. If not, then what is the danger in not being honest and disclosing these conflicts?

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1. Taking an exam

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