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Targeted veteran-specific tobacco intervention programs are needed that consider types of tobacco products being used to improve the health of the full population of veterans. In October 2024, after this study period ended, the VHA implemented new requirements for tobacco screenings, as well as brief counseling or treatment for veterans who use the VHA

Significant challenges persist, primarily the technical difficulty of efficiently separating the plastic filter (cellulose acetate) from residual tobacco, paper, and toxic contaminants like nicotine and heavy metals, alongside achieving cost-effective processing scales

Therefore, it is crucial to conduct studies with robust research designs to track these symptoms longitudinally to determine the temporal relationships between e-cigarette use and the incidence of respiratory symptoms among different e-cigarette users

Spot regarding the negative health effects of smokeless tobacco- smokeless tobacco use is just as harmful and deadly as smoking