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Behavioural factors like condomless anal sex, rough or prolonged sex, fisting, group sex, and drug use before or during sex, particularly among some gbMSM, may further increase transmission risk

Pena could not be reached for comment Thursday

Many have made the switch as, unlike actual cigarettes, they deliver nicotine through a vapor rather than a combustion system as seen with traditional cigarettes

Its completely different from the slow, gradual rise in PM2.5 that might come from cooking or dust

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