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In Reply While our analysis1 of the National Youth Tobacco Survey focused on electronic cigarettes (e-cigarettes), we agree with Delnevo et al that e-cigarettes are not the only alternative nicotine product youth are using, either alone or with cigarettes. The Delnevo et al finding that e-cigarettes remained significantly associated with cigarette smoking even after adjusting for use of other tobacco products indicates that the relationship between e-cigarette use and smoking holds true even after adjusting for dual use of other tobacco products (besides e-cigarettes).
Dutra LM, Glantz SA. Youth Tobacco Use and Electronic Cigarettes—Reply. JAMA Pediatr. 2014;168(8):776-777. doi:10.1001/jamapediatrics.2014.730