“…Furthermore, we found interesting differences in terms of the state-wise prevalence of e-cigarette use during the study period. Looking at higher incremental use of e-cigarettes in states including Arkansas, Colorado, Florida, Indiana, Oklahoma, and Wyoming, call for attention from policymakers especially any conclusive evidence showing beneficial effects of e-cigarettes over combustible cigarette smoking over a long period whereas numerous reports suggesting acute healthcare effects in young individuals using e-cigarettes [ 4 , 10 , 12 ]. Reassuringly, a few states including Arizona, Illinois, New Mexico, and South Carolina, showed a steep decline in the use of e-cigarettes which could be hypothesized due to improved awareness regarding the ill effects of vaping among the general public and physicians.…”