While it is difficult for me to have to criticize anti-smoking groups because these are groups with which I have had a career-long collegial relationship, it appears that these groups are substantially harming the health of the public by impeding smoking cessation. Sadly, this means that their efforts are going to result in a significant amount of unnecessary disease and death.

Here is what each of the three companies/associations had to say regarding this issue in their submitted comments:

2. There is no reason to believe this argument is true in the first place. The percentage of smokers who quit on their own is dismally low. Moreover, the very reason why smokers are trying electronic cigarettes is because they have failed to quit smoking with existing therapies. It is ludicrous to expect that someone who has no confidence in quitting using a traditional methods is suddenly going to quit. In fact, the evidence overwhelmingly shows that without self-efficacy, most smokers are bound to fail. So we are talking about a population of smokers who are not going to quit smoking anyway. Electronic cigarettes are their last best hope. Sure, e-cigarettes are not for everyone and many will fail. But it is simply not true that those who fail are people who would have quit smoking if only they hadn't tried electronic cigarettes.

The truth is that this paper provides no evidence whatsoever that e-cigarette use is a gateway to smoking. Instead, it is entirely possible - and quite likely - that youths who use e-cigarettes are more likely to be heavier and more resistant smokers.

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