There does need to be some restriction on the marketing of electronic cigarettes to youth. The FDA deferred a decision on marketing restrictions at this time. However, it is important that the agency does revisit this issue and that it craft restrictions that carefully balance the desire to protect youth from this advertising with the need for e-cigarette companies to be able to reach adult consumers.

Second, he cites the press release from that study, which opened with the admonition that electronic cigarettes are a gateway to smoking. Clive writes: "There is no basis for drawing this unequivocal ‘gateway’ conclusion from the data presented in the study. None whatsoever – and the published study even makes this clear. In fact the data are consistent with the opposite hypothesis – that e-cigarettes are primarily used by smokers interested in quitting or cutting down. Indeed the observation that users have a higher intention to quit smoking lends support to that hypothesis more than to your preferred explanation."

The rest of the story is that the 2014 Surgeon General's report is violating the very ethical principles that it attacks the tobacco company for violating in the past. While there has been substantial progress in the past 50 years in the area of disclosure of conflicts of interest, somehow that progress has evaded the producers of the Surgeon General's report itself.

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