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According to a consensus report done by the National Academies of Sciences, Engineering, and Medicine, There is conclusive evidence that in addition to nicotine, most e-cigarette products contain and emit numerous potentially toxic substances. The academy also found that, There is substantial evidence that e-cigarette use results in symptoms of dependence on e-cigarettes. The report found that, There is no available evidence whether or not e-cigarette use is associated with clinical cardiovascular outcomes

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However, differences in device-specific delivery of nicotine may result in variability in effects across studies