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?

For this reason, the FDA should think long and hard before jumping into a decision to ban the flavors in electronic cigarettes. It is possible that despite encouraging experimentation among some nonsmoking youth, flavored electronic cigarettes may actually have a net positive effect on the public's health by serving as an overall deterrent to youth smoking.

This is what we call science in tobacco control today?

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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