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However, the observed associations between vaping and subsequent cigarette smoking do not necessarily indicate a causal "gateway effect", as shared social, behavioral, or genetic risk factors may contribute to both behaviors

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Or, slang can simply be another word unrelated to the drug but recognizable to users

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You think because you can't see it, it's not there: In recent discussions with a range of non-Aboriginal central Australian health providers, AR had been informed that ' we don't see women chewing like we used to' or 'we don't see women chewing'