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Second primary exposure: vaping frequency Our second primary exposure of interest was vaping frequency, operationalized as individuals who vape every day (every-day vapers), individuals who vape some days (some-days vapers), individuals who vaped at least once but no longer vape (ever but no longer vapers), and individuals who never vaped (never vapers), determined by the two questions: Have you ever used an e-cigarette, even 1 time? and Do you now use e-cigarettes every day, some days, or not at all? 25

Overall, the National Academy of Sciences report on e-cigarettes found that there is conclusive evidence that completely substituting e-cigarettes for combustible tobacco cigarettes reduces users exposure to numerous toxicants and carcinogens present in combustible tobacco cigarettes. 97 See National Academies of Science, Engineering, and Medicine, Public Health Consequences of Ecigarettes