Between 1961 and 1965 - during the entire time that Dr. Terry was heading the Public Health Service as Surgeon General - the Service was conducting an unethical and racist study in which it denied antibiotic treatment to African American men with advanced syphilis in order to observe the debilitating and fatal long-term sequelae of this essentially 100% treatable infection.

Nevertheless, this does not stop the authors from drawing a conclusion. They conclude, despite their acknowledged inability to draw such a conclusion, that: "e-cigarette use is aggravating rather than ameliorating the tobacco epidemic among youths."

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