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Model 1 describes the classical predictors of MI without any substance-use variables, which are family history of MI, hypertension, moderate and high physical activities, and high cholesterol level

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Michael Siegel, a professor at the Boston University School of Public Health and a career anti-smoking researcher, notes that this obsession with minor differences represents a curious role reversal, with cigarette companies now reminding regulators that "indeed all cigarettes are hazardous and there is no such thing as a safer cigarette." "My opinion is that most, if not all of the substantial equivalence applications involve minor changes that have no substantial bearing on altering the public health significance or impact of the products," says Siegel

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They also sited a CDC report that showed more than 14% of high school students and 3% of middle school students reported current Electronic Nicotine Delivery Systems, or ENDS, use