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The FDA also says e-cigarettes cannot legally be sold as a less hazardous alternative to the conventional kind unless their manufacturers go through the prohibitively expensive process of getting them approved as "modified risk tobacco products." The upshot is that e-cigarette companies are forbidden to be honest about the main benefits offered by their products, a form of censorship that is bound to retard the shift from smoking to vaping, thereby endangering lives that could have been saved by switching to a much less dangerous nicotine habit

Using alcohol, benzodiazepines, opioids, or other substances worsens symptoms and makes interpretation more difficult

While data for the most recent years is not reportable for most age groups, the available data indicate that smoking prevalence decreased substantially in all age groups in the early 2000s, with little change observed since