Tony Gwynn's at age 54 from repeated smokeless tobacco use is the reason why. While it is not common, traditional smokeless tobacco use is clearly associated with oral cancer. In addition, there is little evidence that as marketed and used in the United States, these products are helping a substantial proportion of smokers to stay off cigarettes.

Despite its obvious bias against electronic cigarettes, what was the worst thing that SAMHSA could say about the health risks of vaping:

In their to this response, the authors of the study clarify their reasoning for attacking the cigarette companies, even though they merely complied with the law:

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