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The authors noted that despite the lack of understanding of the long-term health impact of e-cigarette use, the contribution of current e-cigarette use to rising healthcare spending is significant and should not be overlooked. This excess spending is particularly relevant for employers, who cover over half of Americans through employer-sponsored health insurance

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Review criteria Original studies and review articles that provided information on the determinants and epidemiology of cardiovascular health, as described by the framework presented in this Review, were included from a MEDLINE search supplemented by personal libraries (Supplementary Box 2)

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