Many youths who use e-cigarettes additionally smoke traditional cigarettes. Using policy variation is vital as it avoids the methodological challenge that many e-cigarette users are high-threat individuals that will have in any other case smoked cigarettes and will now use e-cigarettes first to “test the waters” before transitioning to their a-priori preferred choice of cigarettes. This contrasts with much of the literature not using coverage variation and spuriously concluding that e-cigarettes are gateways to subsequent cigarette use, which doesn’t align with noticed patterns of tobacco use.
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