Well, Polosa et al. have conducted exactly such a . They examined the changes in asthma symptoms among smokers who continue to smoke versus those who switch to electronic cigarettes. These investigators reported that in contrast to real cigarettes, the fake ones result in actual harm reversal. Lung function, asthma control, and asthma symptoms were significantly improved among patients who switched from regular cigarettes to electronic cigarettes. These improvements were even observed among patients who became dual users of both real and fake cigarettes.

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?

Lastly inhaling caffeine is not the best way to get caffeine into your bloodstream apparently. From this study , it seems caffeine is only 60% potent when inhaled versus ingested orally.

In other words, despite acknowledging that they cannot tell from their study whether e-cigarette use precedes smoking or whether smoking precedes e-cigarette use, they nonetheless draw the conclusion that e-cigarette use precedes smoking.

Actually, what is completely disingenuous is the attempt of these politicians to pretend that they are committed to ending the use of flavorings to addict youth to nicotine. The rest of the story is that these same lawmakers chose not to ban the use of cigarette flavorings to addict youth to nicotine. Specifically, they have supported an exemption for menthol, which is the number one flavor used by cigarette companies to addict youth to nicotine and cigarette smoking.

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