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through VA health care): $21.8 billion Annual health care expenditures solely from secondhand smoke exposure: $6.5 billion Additional smoking-caused health costs caused by tobacco use include annual expenditures for health and developmental problems of infants and children caused by mothers smoking or being exposed to second-hand smoke during pregnancy or by kids being exposed to parents smoking after birth

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With distribution networks already well-developed, criminal gangs are poised to expand into vapor products

"In recent years, these companies have become much more sophisticated, up to the point where it's impossible to tell the difference between the counterfeit cigarettes and the actual cigarettes." And, he says, law enforcement's efforts are often hindered by a lack of resources - and other priorities

This lack of scientific review makes it impossible to determine which products reduce harms and help smokers switch completely from combustible products