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Although we cannot make causal inferences from these correlational data, the 2017 ATS provides some evidence in support of ENDS use as a potential gateway to smoking: 54% of current, former, and experimental smokers (see Table 2 for a summary of the four smoking status categories) who thought ENDS were available when they started smoking used ENDS before smoking a cigarette.

For many years it has been believed that polycyclic aromatic hydrocarbons, particularly benzo(a) pyrene, play a major role in the development of lung cancer

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