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There is no available evidence whether or not e-cigarettes cause respiratory diseases in humans, the report concludes

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Smoking costs the United States almost $170 billion in direct medical care for adults and over $156 billion in lost productivity due to exposure to secondhand smoke and premature death

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Kenneth Warner, a professor emeritus of public health at the University of Michigan, said, "This study shows an increased probability of trying a cigarette if they've tried a vape, but I don't believe they establish a causal relationship." Warner also pointed out that the results don't quite mesh with findings from national studies that show the use of tobacco cigarettes has gone down for the past five years, and the use of e-cigarettes dropped in youth nationally in 2016