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I could say this to my therapist, or I could say this to the world, he says

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From its pre-colonial use to its transformation through European influence and the challenges faced today, tobacco remains an integral part of their identity

Harm Reduction Prevails Anyway Despite the pessimistic bias of including dual-use in the EC switchers group, they actually did have favorable health outcomes compared to the exclusive smoking group, demonstrating harm-reduction: Paper 1 (COPD) found that those using ECs after 1 year had significantly lower odds of MACCE after 5 years (adjusted hazard rate (AHR) = 0.80) which was a similar reduction in risk found in those who quit all nicotine (AHR = 0.85)