Vaping is not an isolated substance use behavior, and combined use with other products may potentiate harms by complicating intervention efforts, strengthening other sub­stances’ effects, and increasing the physiological toll on adolescents. Adding to the negative effects of vaping, vaping nicotine is associated with use of cannabis, alcohol, and several other substances …Given the strong associations between nicotine use and both cannabis use and binge drinking, there is a need for sustained interventions, advertising and promotion restrictions, and national public education efforts to reduce adolescent nicotine vaping, efforts that acknowledge co-occurring use.

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