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.

If I had to characterize the two camps, I wouldn't characterize them as optimists vs. pessimists. I would characterize them as scientists who are actually talking to vapers and considering their experiences versus those who are stuck in ivory towers. I would characterize them as scientists who are pure idealists versus those who live in the real world. And finally, I would characterize them as scientists who are paying attention to the actual scientific evidence versus those who are ignoring the evidence and basing their opinions on ideology.

The beauty of a randomized study is that it can equalize the levels of smoking addiction, reasons for wanting to quit, and motivation to quit across groups. In addition, it equalizes other confounders, including unknown confounders which could affect the study results. There is no way for a survey study to accomplish this. Thus, to simply throw out the RCT is quite unscientific, in my opinion. It throws out one of the most valid pieces of evidence that is necessary to make an informed judgment about the effect of these products: the differences in effectiveness of the products under conditions in which confounding cannot throw off the results.

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