Fortunately, there is a simple way to evaluate this hypothesis, at least on a preliminary basis, prior to waiting for the results of longitudinal studies. Enough youth are experimenting with electronic cigarettes, and the increase in youth e-cigarette use has been dramatic and sustained enough, that if the gateway hypothesis were correct, we would be starting to see an increase in smoking prevalence among youth due to the many new smoking initiates that were converted from e-cigarette experimentation to smoking.

This is an ironic reversal from the past, where it was the public health groups sending the anti-smoking messages and the tobacco industry which was undermining those anti-smoking messages.

In her on CDC's "Tips from Former Smokers" anti-smoking campaign, Nancy Wride of Elements Behavioral Health made an interesting observation. On its web site describing a variety of possible strategies to quit smoking, the CDC does not list electronic cigarettes. Wride therefore asked the CDC why electronic cigarettes are not included on its web site as a potential smoking cessation aid.

For this reason, I am discouraged about the possibility that people like Dr. Glantz and Dr. Chapman will change their minds about the potential utility of e-cigarettes if further evidence accumulates to demonstrate the benefits of these products. The science is simply not going to matter to them. Hopefully, the science will matter to the FDA.

In the paper, the authors ackowledge that:

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