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This would occur if the smokers who choose to use e-cigarettes are less likely to succeed because of stronger nicotine dependence, less access to or interest in using effective smoking cessation medications, having failed to quit after having exhausted all other smoking cessation aids, or other factors that could bias relative risk estimates of associations with e-cigarette use toward less favorable cessation outcomes

Cigarette card for Allen & Ginter ( Virginia , USA ) for the " World's Inventor " souvenir album , 1888

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