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While 20 PY smokers with age at initiation 20 also had elevated risks of MI (HR 1.82 [1.781.86]), stroke (HR 1.38 [1.361.41]), MI or stroke (HR 1.52 [1.501.54], and all-cause death (HR 1.41 [1.391.42]), they were significantly lower than the risk increase observed in smokers who started before age 20 ( Supplementary Table S1 )

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The liquid inside may smell fruity, but it can have a high nicotine content

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