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It has also been noted that many people continue to smoke and use heat-not-burn devices, and therefore end up increasing their nicotine consumption but without any decrease in health risk compared to someone who just smokes

doi: 10.1176/appi.ajp.2007.07091486

Congressional efforts to repeal, delay, or replace Section 781 are underway but have not produced a floor vote as of April 2026

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