Fox writes: "The tobacco control community should strive for transparency in its dealings. If the tobacco control community fails to explain its dealings within an appropriate framework, it may be perceived as biased or hiding relationships, and it could lose its reputation for independence."

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."

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?

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