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And tobacco companies discovered long ago that adding ammonia to cigarette tobacco created a form of nicotine that was more desirable, and more addictive to the user

[21] A 2016 review found low-quality evidence of a trend towards benefit of e-cigarettes with nicotine for smoking cessation

Either way, if the FDA is not provided with the regulatory tools to take appropriate enforcement action against these new and emerging products marketed as PMTA Exempt, the FDAs authority and its capability to protect public health are further undermined