The rest of the story, then, is that health advocates in Michigan are so blinded by ideology (that anything that looks like a cigarette is evil) that they are on the exact opposite side of the issue as they should be. First, they are opposing the prohibition of the sale of e-cigarettes to minors. Second, they are in favor of protecting the sale of tobacco cigarettes by removing all competitive advantage that e-cigarettes hold in the marketplace.

Thus, it appears that cigarette filters did produce a small but measurable decline in cancer risks associated with smoking, while further design changes that lowered tar levels did not. In other words, there is evidence that filtered cigarettes produce lower cancer risks than non-filtered cigarettes. However, within the filtered cigarette category, there is no evidence that low-tar cigarettes confer any reduced cancer risk.

Fortunately, there is a simple way to evaluate this hypothesis, at least on a preliminary basis, prior to waiting for the results of longitudinal studies. Enough youth are experimenting with electronic cigarettes, and the increase in youth e-cigarette use has been dramatic and sustained enough, that if the gateway hypothesis were correct, we would be starting to see an increase in smoking prevalence among youth due to the many new smoking initiates that were converted from e-cigarette experimentation to smoking.

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