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Yesterday, I that this month's issue of JAMA features a co-authored by Dr. Michael Fiore (from the University of Wisconsin School of Medicine and Public Health) which reviews the history of tobacco control in the 50 years since the release of the 1964 Surgeon General's report. Although the article discloses no conflicts of interest, I revealed that Dr. Fiore has a long and intensive history of financial conflicts of interest with the very pharmaceutical companies that manufacture smoking cessation drugs, which he recommends, in the article, be prescribed to every patient who smokes.

Of course, this is the same thing as stating that cigarette smoking may be no worse than vaping in terms of its effects on pulmonary function.

Neither the survey approach or the RCT approach is perfect. Both have major strengths and significant limitations. The best way to proceed is to conduct both types of studies and to synthesize the results across study designs, keeping in mind the methodological strengths and limitations of each individual study. Only by looking at this totality of the evidence can we draw valid scientific conclusions.

In a submission to the FDA regarding the proposed deeming regulations, Stan Glantz and colleagues have called on a by electronic cigarette companies: namely, stating that electronic cigarettes are safer than tobacco cigarettes. The authors of this comment want the FDA to expressly prohibit electronic cigarette companies from informing consumers that vaping is safer than smoking.

In a Tobacco Control by the Center for Tobacco Products at the FDA, the agency states: "While e-cigarette aerosol may contain fewer toxicants than cigarette smoke, studies evaluating whether e-cigarettes are less harmful than cigarettes are inconclusive."


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