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This study suggests the possibility of harm reduction if e-cigarette use were completely substituted for tobacco smoking, although the study was not designed to answer this question and selection into the cohort for nonusers was unclear

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By standing among the Amish farmers talking in thick Pennsylvania Dutch accents, many smoking or chewing tobacco, Stoltzfus gets a forecast for the season: what type of tobacco will be in greatest demand, the price per pound brokers will offer and how many acres his fellow farmers intend to plant