Here, they find a correlation between e-cigarette use and higher and more sustained levels of smoking. But because this is a cross-sectional study, they cannot determine which came first. In other words, what is the direction of the causal relationship? Does the e-cigarette use precede, and cause, the smoking? Or does the smoking precede, and cause, the e-cigarette use?

Would one therefore conclude that taking an exam is just as risky, in terms of respiratory effects, as smoking a cigarette? Apparently, Dr. Glantz would draw such a conclusion. But it is easy to see why this is an inappropriate conclusion. And we would never disseminate messages to the public that smoking is no more hazardous than taking an exam.

In summary, this study helps to alleviate concerns raised by prior research and does not raise any new concerns. While more research is clearly needed, especially because there are so many different brands of electronic cigarettes on the market, the current evidence does not point to any substantial health hazards associated with passive vaping.

For the combustible cigarette market, this is a dream come true. In fact, it seems too good to be true because it is a supposedly public health protection agency that is issuing this immense market protection.

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