"This is a blatant attempt at rent-seeking by an obvious vested interest. We know that the pharmaceutical industry has been lobbying hard to hamper the growth of e-cigarettes so it comes as no surprise to find Glaxo using the tired old gateway argument. The truth is that e-cigarettes will only "seriously disadvantage" the NRT market if they work better as quitting aids. In my experience—and the experience of countless other people—e-cigarettes are much better substitutes for smoking. If they were really a "gateway" to smoking, e-cigarettes would be good for companies like Glaxo as they would create more smokers (NRT companies need there to be smokers just as much as cigarette companies do)."

In the absence of data demonstrating that flavored electronic cigarettes are serving as a gateway to youth smoking, there is no public health justification for a ban on flavors in electronic cigarettes, and such a measure could cause more public health harm than good.

"Inhaling tons of smoke from burning sticks full of harsh chemicals and dried leaves has been proven to be a highly efficient method of creating many murderous cancers. But while very addictive, not healthy, and not something we should be letting children purchase, nicotine use by itself is but a tiny fraction of tobacco’s threat. Confusing these problems is like comparing shoplifting a t-shirt with aggravated murder. Reporting recently on the toxicology of e-cigarettes, the British National Health Service stated the vapors contain 1/1000th the hazardous chemicals of real cigarettes. Those anti-smoking billboards on roadsides showing people with chunks of their face and lungs missing are showing the ravages of tobacco smoke, not nicotine use. To conflate the two ... is - at best - blindingly stupid regarding the facts ... . At worst, it is profoundly immoral propaganda that confuses and distracts people with a lethal addiction regarding a life-saving alternative. We now have the ability to separate smoking death from nicotine addiction. That should be a goal of health policy, not an obstacle."

Although the survey approach described above would lead to "invalid" results, I would never argue that survey studies should be thrown out and that we should only be conducting RCTs. My point is that there are strengths and limitations of various study designs, and causal inference is enhanced by having research evidence from multiple study designs. On balance, the strengths and weaknesses balance each other out, leading to a much greater ability to draw valid conclusions.

But it doesn't end there.

Of course, this is the same thing as stating that cigarette smoking may be no worse than vaping in terms of its effects on pulmonary function.

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