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A Cochrane systematic review of the evidence concludes that there is high certainty evidence that vapes that contain nicotine increase long-term quit rates to a greater extent than Nicotine Replacement Therapy (NRT).[4] Furthermore, there is high certainty evidence that nicotine e-cigarettes, varenicline and cytisine are the stop-smoking aids most likely to help people quit smoking.[5] Varenicline and cytisine are only available on prescription and were used in less than 1% of quit attempts in 2022.[6] Vaping behaviour in never smokers About one in 70 adults who have never smoked currently vape (1.5%, Figure 5)

++ Codify a policy for recouping advance investment payments from ACOs whose participation agreements are terminated by CMS (section III.G.6.b of this proposed rule)

The 2012 US Surgeon Generals report 74 identified product design as a factor that may contribute to smoking initiation among young people, with features like ventilation making smoke feel less harsh and therefore more appealing to novice users

Nicotine can trigger the adrenal glands, causing a slight uptick in testosterone-producing activity

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