The prevalence of e-cigarette use was only in the low single digits a few years ago but currently reaches ≥30% among high school students, and at least half are regular users.1,2 This rapid explosion of e-cigarette use has caught the field by surprise, and researchers are scrambling to understand the implications for public health.

In their paper “Adolescent Risk Behaviors and Use of Electronic Vapor Products and Cigarettes,” Demissie et al3 provide a useful new perspective on this phenomenon. The researchers showed that 16% of the adolescent population used e-cigarettes only, 3% only smoked cigarettes, and 8% were dual users (cigarettes and e-cigarettes). The good news is that 73% of the adolescent population did not use any tobacco-related product (nonusers). However, that 27% of adolescents still do is not comforting to public health researchers and advocates. Here I bring out 3 points about how this paper...

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