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First, the cross-sectional design precludes causal inference

Diagnostics 13 , 3677 (2023)

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The trace-nicotine model no longer a nicotine end-game strategy While initially in 1994 the nicotine-reduction strategy said nothing about supplemental nicotine, the model in the hands of its leading scientific proponents (and creators) has evolved to require that less-harmful nicotine sources be provided: The key to successful cigarette nicotine reduction is likely to lie with providing readily available, consumer-acceptable non-combusted forms of nicotine to support shifting the source of nicotine from cigarettes to a non-combusted productWe recommend that regulations regarding e-cigarettes and other ANDS [alternative nicotine delivery systems] focus on toxicity, safety and limiting youth uptake, but do not disrupt features that make them viable alternative to cigarette smoking. The evolved approach should spur the AMA, FDA and WHO to advance safer, satisfying forms of nicotine products before, if ever, trying to ban traditional cigarettes