On 2016 Aug 10, Gerry Stimson commented:

In addition to the comments made by Clive Bates about the limitations of the study, a further fault is that the research measured e-cigarette use, and did not establish whether the e-cigarettes actually contained nicotine. As the paper reports 'Students were selected as ever e-cigarette users if they responded “yes” to the question “have you ever tried an e-cigarette”'. But the majority of youth vapers in the US do NOT use nicotine-containing e-cigarettes. The Monitoring the Future study reported that about 60% of youth vapers use e-cigarettes without nicotine. Lax scrutiny by the editor and reviewers means that this crucial issue is overlooked - indeed the article authors do not appear to have identified that this is as a limitation. This further undermines the rather facile policy recommendations to limit e-cigarette availability to young people.

On 2016 Aug 10, Clive Bates commented:

The authors appear to have discovered that people want to use e-cigarettes instead of smoking. For anyone taking a public health perspective, that is a positive development given they are likely to be at least 95% lower risk than smoking and nearly all e-cigarette users are currently (or otherwise would be) smokers.

The authors' policy proposals as stated in their conclusion do not follow from the observations they have made. The paper is insufficiently broad to draw any policy conclusions as it does not consider the interactions between vaping behaviour and smoking behaviour or wider effects on adult or adolescent welfare from increasing costs or reducing access. The paper does not give any insights into the effectiveness, costs, and risks of the proposed policies, so the authors have no foundation on which to make such recommendations.

The authors appear to be unaware of the potential for unintended consequences arising from their ideas. For example raising the cost of e-cigarettes may cause existing users to relapse to smoking or reduce the incentive to switch from smoking to vaping. They believe their policies will "be important for preventing continued use in youth", but the reaction may not be the one they want - complete abstinence. It may be a continuation of, or return to, smoking.

Finally, editors and peer reviews should be much firmer in disallowing policy recommendations based on completely inadequate reasoning and, in this case, on a misinterpretation of their own data in which they mischaracterize a benefit as a detriment and an opportunity as a threat.

On 2016 Aug 10, Clive Bates commented:

The authors appear to have discovered that people want to use e-cigarettes instead of smoking. For anyone taking a public health perspective, that is a positive development given they are likely to be at least 95% lower risk than smoking and nearly all e-cigarette users are currently (or otherwise would be) smokers.

The authors' policy proposals as stated in their conclusion do not follow from the observations they have made. The paper is insufficiently broad to draw any policy conclusions as it does not consider the interactions between vaping behaviour and smoking behaviour or wider effects on adult or adolescent welfare from increasing costs or reducing access. The paper does not give any insights into the effectiveness, costs, and risks of the proposed policies, so the authors have no foundation on which to make such recommendations.

The authors appear to be unaware of the potential for unintended consequences arising from their ideas. For example raising the cost of e-cigarettes may cause existing users to relapse to smoking or reduce the incentive to switch from smoking to vaping. They believe their policies will "be important for preventing continued use in youth", but the reaction may not be the one they want - complete abstinence. It may be a continuation of, or return to, smoking.

Finally, editors and peer reviews should be much firmer in disallowing policy recommendations based on completely inadequate reasoning and, in this case, on a misinterpretation of their own data in which they mischaracterize a benefit as a detriment and an opportunity as a threat.

On 2016 Aug 10, Gerry Stimson commented:

In addition to the comments made by Clive Bates about the limitations of the study, a further fault is that the research measured e-cigarette use, and did not establish whether the e-cigarettes actually contained nicotine. As the paper reports 'Students were selected as ever e-cigarette users if they responded “yes” to the question “have you ever tried an e-cigarette”'. But the majority of youth vapers in the US do NOT use nicotine-containing e-cigarettes. The Monitoring the Future study reported that about 60% of youth vapers use e-cigarettes without nicotine. Lax scrutiny by the editor and reviewers means that this crucial issue is overlooked - indeed the article authors do not appear to have identified that this is as a limitation. This further undermines the rather facile policy recommendations to limit e-cigarette availability to young people.