Update 1/18/2016 by Jeremy Kaplan: This article was updated to include criticism of the study from other researchers.

The controversy surrounding e-cigarettes was previously muted by the promise that, despite their flaws, they do help smokers quit smoking. But now, even that silver lining has been disproven — maybe. Not only do e-cigarettes not help you kick the habit, a new meta-analysis argues, but they may have the exact opposite effect. Indeed, e-cigarette smokers are 28 percent less likely to quit than individuals who’ve never used these devices at all, it claims.

The study, released online Thursday in well-regarded medical journal The Lancet Respiratory Medicine, was comprised of a systematic review and meta-analysis of 38 studies looking at the link between e-cigarette use and smoking cessation among smokers as young as 15 years old. According to lead author Dr. Sara Kalkhoran (now at Harvard Medical School), this research marks the largest study yet performed on the effects of e-cigarettes on traditional smoking habits.

“E-cigarettes should not be recommended as effective smoking cessation aids until there is evidence that, as promoted and used, they assist smoking cessation,” Kalkhoran wrote.

E-cigarettes work by using batteries to heat nicotine and various flavors that users inhale as a vapor comparable to cigarette smoke. But because there’s no tobacco involved, it’s considered the “healthier” alternative. While e-cigarettes have previously been heralded as a potential substitute for their carcinogenic tobacco-laden counterparts, last year, the U.S. Preventive Services Task Force noted that there wasn’t enough evidence to market the devices as a quitting solution.

And now, the evidence may have turned the tables entirely.

“The irony is that quitting smoking is one of the main reasons both adults and kids use e-cigarettes, but the overall effect is less, not more, quitting,” said co-author Stanton A. Glantz, PhD, professor of medicine and director of the Center for Tobacco Research and Education at UCSF. “While there is no question that a puff on an e-cigarette is less dangerous than a puff on a conventional cigarette, the most dangerous thing about e-cigarettes is that they keep people smoking conventional cigarettes.”

But the study is not without controversy. Other researchers were quick to counter the findings, noting that the very methodology of the study — a meta-analysis of other papers — is at its heart flawed.

“While its breadth is to be commended, its conclusions (that e-cigarettes don’t work for smoking cessation) are at best tentative and at worst incorrect,” noted Linda Bauld, Professor of Health Policy at the University of Stirling and Deputy Director of the UK Centre for Tobacco and Alcohol Studies. “Attempting to directly compare the results of a body of literature that uses such a wide range of study designs and includes such variable (and often poorly defined) populations and outcomes is difficult, if not impossible.”

Robert West, Professor of Health Psychology at University College London, took the critique even further, calling it a failure on the part of Lancet.

“Publication of this study represents a major failure of the peer review system in this journal.”

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