It is not the case that the authors are simply unaware of the inability of their study to conclude that the e-cigarette use is leading to regular cigarette smoking. They readily acknowledge this in the study. Nevertheless, both of the authors still make conclusive statements to the public, misleading us to believe that the study demonstrates that e-cigarettes are a gateway to regular cigarette use.

While it is theoretically possible that an electronic cigarette company could some day get a full reduced risk claim approved, the regulatory burden is extreme. Not only would the company have to show that the product is safer than smoking, but the company would also have to demonstrate that the product will not deter smokers from quitting and will not introduce youth to the use of nicotine. The studies required would be substantial. For most companies, the costs would be prohibitive. It would take many years before any company could even have a reasonable chance of getting such an application approved and by then it will be too late for the market to continue to expand.

Dr. Glantz is simply wrong. There is abundant evidence which demonstrates that while vaping does cause some degree of respiratory irritation (and probably triggers a bit of inflammation), it is far safer than smoking and has far less of an effect on lung function.

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