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The prevalence of e-cigarette use has been increasing among adolescents and adults in both the US8 and Europe.9 In adults, the highest prevalence is in current conventional cigarette smokers, of whom 31% report having tried electronic cigarettes.9 There are few studies documenting use trends in older smokers and none in individuals with established smoking-induced lung disease such as chronic obstructive pulmonary disease (COPD)

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[15, 22] Reducing youths access to tobacco products is key for their health

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No smoking product is safe