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While it is reasonable to assume that, if existing smokers switched completely from conventional cigarettes (with no other changes in use patterns) to e-cigarettes, there would be a lower disease burden caused by nicotine addiction, the evidence available at this time, although limited, points to high levels of dual use of e-cigarettes with conventional cigarettes, no proven cessation benefits, and rapidly increasing youth initiation with e-cigarettes, the authors wrote

This encourages more users to switch to these safer alternatives

As this occurs, competitive rivalry shifts toward packaging clarity, consistent sensory delivery, and reliable availability of the anchoring flavors

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