Long-time tobacco opponent Professor Simon Chapman, from Sydney University, said describing e-cigarettes as medicine was "Orwellian" and destructive to society.

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?

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