In other words, despite acknowledging that they cannot tell from their study whether e-cigarette use precedes smoking or whether smoking precedes e-cigarette use, they nonetheless draw the conclusion that e-cigarette use precedes smoking.

You see, there is no question that huge reductions in cigarette consumption improve respiratory symptoms. My patients who were able to cut down substantially on their smoking experienced immediate improvements in their ability to exercise and were able to enjoy life more because they could do more things without getting short of breath. Research confirms that respiratory symptoms improve when smokers are able to cut down the amount they smoke by at least 50%.

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