The Rest of the Story

Furthermore, later in the paper they reinforce this point more specifically, writing: "the cross-sectional nature of our study does not allow us to identify whether most youths are initiating smoking with conventional cigarettes and then moving on to (usually dual use of) e-cigarettes or vice versa...".

Second, in dual users, the total amount of nicotine intake declines. The increase in electronic cigarette use over time is accompanied by a concomitant decline in cigarette smoking. Thus, overall nicotine declines.

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