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No strategic framework governing the national reaction between 2016 and 2021, when a revised framework was developed and currently guides the national response 19

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Although e-cigarette vapors contain significantly lower levels of carcinogenic toxicants than traditional tobacco does 44 , there is strong debate surrounding the harmfulness of e-cigarette vapors compared with traditional cigarettes and whether they are associated with reduced health risks, especially regarding lung cancer and other tobacco-related malignancies