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A 2018 National Academies of Sciences, Engineering, and Medicine reportconcluded that there is substantial evidence that e-cigarette use increases risk of ever using combustible tobacco cigarettes among youth and young adults. A study by the University of Pittsburgh Schools of the Health Sciences found that young adults who use e-cigarettes are more than four times as likely to begin smoking tobacco cigarettes within 18 months as their peers who do not vape

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