(See: Brown J, Beard E, Kotz D, Michie S, West R. Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study. Addiction. .)

It is easy to see why this methodology is inappropriate to assess smoking cessation rates among smokers who use e-cigarettes in an attempt to quit smoking.

This argument might have some plausibility if electronic cigarettes were "starter cigarettes." In other words, if electronic cigarettes were much milder versions of tobacco cigarettes, with milder tobacco flavor, then it might be expected that youth could advance from an electronic cigarette to a real one. Electronic cigarettes with tobacco or menthol flavoring, for example, might be expected to get kids used to the taste of a tobacco cigarette and thus to promote cigarette smoking initiation.

In other words, despite acknowledging that they cannot tell from their study whether e-cigarette use precedes smoking or whether smoking precedes e-cigarette use, they nonetheless draw the conclusion that e-cigarette use precedes smoking.

3. CDC web site

The study analyzed the levels of a large number of pollutants in the ambient air of a room in an office building during the presence of three smokers using electronic cigarettes. The room was moderately ventilated at 0.56 air changes per hour.

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