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"We've made great strides with our awareness campaigns and our policies." Some of the progress can be chalked up to the Master Settlement Agreement, a $200 billion settlement between large tobacco companies and 46 states to help compensate them for tobacco-driven health problems

Additionally, questions persist about the potential dangers of e-cigarettes, stemming from the exposure to potentially harmful substances in their emissions, particularly among individuals who are new to tobacco use, such as adolescents and young adults

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Inclusion & ethics statement All authors contributed meaningfully to this manuscript, ensuring equitable representation of diverse perspectives

Anyone experiencing serious symptoms, such as throwing up large amounts of blood, should seek immediate medical attention