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Critics argue that it may be an artifact of selection bias, notably bias introduced by hospital-based recruitment of participants, rather than a true biological effect 14

Additionally, this is consistent with other studies demonstrating negative impacts of e-cigs on the airway and host defenses

They also may not be generalizable to all e-cigarette products, or to different policy and regulatory contexts. Long-Term Use Concerns An important finding of the trial was that the proportion of participants in the e-cigarette group who quit smoking but continued to use e-cigarettes at one year was much greater than the proportion of participants in the nicotine replacement group who continued to use nicotine replacement therapies after one year, Dr

Biol Trace Elem Res 202(12):53495355

The other class-action suits are also seeking billions of dollars, amounts exceeding the funds the companies actually have