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among these, 71.5 percent of individuals ages 18 to 20 years had never smoked combustible cigarettes (31)Bandi P, et al

The death rate was almost twice as many as the average of 17

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This is predictable, because the higher dose of nicotine delivered by e-cigarettes can effectively surmount nicotine tolerance, satisfying the drive for a nicotine "buzz." Switching to e-cigarettes would only be harm-reducing if the products cause less health damage than traditional cigarettes