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We cannot determine whether e-cigarette use preceded or followed the development of hypertension, nor can we exclude the possibility that individuals who switched to e-cigarettes were systematically healthier or more health-conscious than those who continued smoking, introducing selection bias

Cigarettes are not actually sold by those sites
Smoking cigarettes is the most common way to use tobacco

And that still holds true despite the optical appearance of paper rods, which have a much larger mesh than cellulose acetate
