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Similarly, when considered at a population level, concerns around a gateway effect have not come to pass in other comparable nations such as the United Kingdom [74], New Zealand [75], Canada [76] or the United States [77] where large-scale population surveys have similarly revealed steep declines in smoking prevalence coinciding with increased uptake of vaping

45 The RYO smokers in our sample appeared to have very limited interest in quitting, which may help explain the findings with respect to their perceived behavioral impact in response to inserts

Smokeless tobacco is safer than combustible tobacco, but there are some smaller risks associated with long-term use

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