The requirement by the FDA that this black box warning be placed on Chantix is based on the agency's assessment of hundreds of cases of suicides that occurred in patients who had recently been treated with the drug, as well as thousands of cases of other serious adverse neuropsychiatric symptoms associated with the use of Chantix. In making a decision to require a black box warning, the agency takes into consideration the likelihood that the observed association between the drug and the adverse effects is a causal one.

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.

Last Wednesday, the Senate Committee on Commerce, Science, and Technology held a hearing on the marketing of electronic cigarettes. Several senators, including Jay Rockefeller (D-WV), Barbara Boxer (D-CA), and Richard Blumenthal (D-CT) harshly attacked the two electronic cigarette company executives who testified before the committee, calling them liars who are doing harm to the public and comparing them to the Big Tobacco executives of the past.

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