The authors admit this in the paper. They write: "This is a cross-sectional study, which only allows us to identify associations, not causal relationships."

But beyond the issue of medical or public health malpractice, I am most concerned about the simple principle of honesty. As medical and health professionals, our very first obligation is to be truthful with our patients and with the public. The information being provided by this respiratory therapist is untruthful. It is simply not the case that smoking may be less hazardous than vaping. There is no credible scientific debate about that issue in the year 2014.

While the deeming regulations pretend to acknowledge that there is "a continuum of nicotine-delivering products" in terms of their health risks, the truth is that the agency fails to acknowledge that the most hazardous product along that continuum - cigarettes - are any more hazardous than the least dangerous product (non-tobacco electronic cigarettes).

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