The study concludes that "e-cigarette use is aggravating rather than ameliorating the tobacco epidemic among youths."

The study finds that e-cigarette use is associated with smoking status. In addition, e-cigarette use is associated with heavier smoking and with fewer periods of smoking abstinence.

Because of the importance of this issue, I have written to the editorial staff of JAMA, urging them to publish a corrective statement, requiring Dr. Fiore to disclose his long and intensive history of conflicts of interest with pharmaceutical companies that manufacture smoking cessation drugs.

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