The authors admit this in the paper. They write: "This is a cross-sectional study, which only allows us to identify associations, not causal relationships."

According to the article: "The U.S. surgeon general's landmark finding last week that filtered cigarettes may actually increase the risk of lung cancer could lead to a flurry of new lawsuits against tobacco companies and even expand cigarette litigation outside of Florida, where it has flourished for nearly a decade."

The non-broadcast and broadcast rules have been harmonised. Whilst ads for e-cigarettes have been able to appear on TV, previously actual depictions of e-cigarettes in those ads were prohibited. The changes mean that from next month e-cigarettes can be shown, including in use, in ads across UK media, on the condition that the ads comply with the strict new rules.

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Nevertheless, this does not stop the authors from drawing a conclusion. They conclude, despite their acknowledged inability to draw such a conclusion, that: "e-cigarette use is aggravating rather than ameliorating the tobacco epidemic among youths."

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