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This paper describes the introduction, development, and proliferation of new electronic nicotine delivery systems (ENDS). The use of non-combustible tobacco products is considered a means for improving public health and reducing the mortality attributed to cigarette smoking. The effects and use of ENDS are described, with studies to date indicating that, despite differences in toxicity, there is insufficient evidence that ENDS leads to smoking cessation. Finally, research questions are proposed to address key unanswered questions about the effects of such systems.

E-cigarettes/electronic nicotine delivery systems: a word of caution on health and new product development