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.

I find it quite ironic that the health groups, including CDC and FDA, are undermining the efforts of even tobacco companies to develop the non-combustible market and shift a proportion of their sales from combustible to non-combustible products. And the CDC and FDA are completely undermining the efforts of the non-tobacco-related e-cigarette companies to promote e-cigarettes over real tobacco cigarettes.

Hopefully, Dr. Foulds and his group will next repeat the study using a sample of dual users (electronic cigarettes and regular cigarettes) to determine whether or not dual users experience a similar reduction in their overall level of smoking addiction.

"Analysis of indoor air quality during vaping sessions showed that e-cigarettes are not emission-free." This was the second time the authors used this phrasing to summarize their findings. Right now, that e-cigarettes are not emission free appears to be about the most alarming thing that can be said about them.

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