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Birger Hjrland, and the two anonymous referees for providing their valuable feedback, including detailed, knowledgeable, and fruitful suggestions for improving the original manuscript

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Nicotine and ENDS product use can both lower brain glucose utilization and increase vascular stiffness, which may enhance the risk of ischemic brain injury or stroke ( 76 )

It is affecting students, and it just needs to stop. A 2017 Hawaii Health Department study found 16 percent of middle schoolers and 26 percent of high school students were current users of e-cigarettes