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Using CSM-II, among adolescents who ever used electronic cigarettes in the third wave, six percent of individuals began smoking cigarettes in the fourth wave and continued to smoke in the fifth wave, compared to one percent among those who never used electronic cigarettes

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The findings highlighted the need for culturally tailored public health interventions that account for sociocultural drivers such as peer influence, stress-related vaping behaviors, and access regulation

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Pampel, F