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.

Hartge et al. exactly the same result as Wynder's group: "Our data indicated that people who have only smoked unfiltered cigarettes have higher risks."

This provision is going to present a huge obstacle to innovation in this category. The newer products tend to be safer and more effective, so it makes no sense to allow the older products to remain on the market while requiring pre-approval for the newer and better products. The implications of this regulation is going to depend on the evidence that the agency requires to approve these applications. A stringent interpretation of the regulations will put a huge dent in electronic cigarette innovation and could limit the expansion of the market. In addition, this provision is going to place an undue burden on smaller companies and give a huge advantage to larger companies, including the tobacco companies that have entered the e-cigarette market.

Raising the tax for electronic cigarettes would put many small business owners out of business as most customers would not be willing to pay such a markup as they can easily purchase out of state or even online for much cheaper. Yes they can do this now but the percentage saved is marginable compared to the amount saved if they do decide to act on this tax spike. If you feel as strongly as I do about this ridiculous tax, whether you are a Pennsylvania resident or not.

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