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Similarly, when considered at a population level, concerns around a gateway effect have not come to pass in other comparable nations such as the United Kingdom [74], New Zealand [75], Canada [76] or the United States [77] where large-scale population surveys have similarly revealed steep declines in smoking prevalence coinciding with increased uptake of vaping

In contrast, those in routine or manual jobs often face higher levels of occupational stress, less job control, and fewer institutional supports for quitting, which may reinforce continued smoking and shape the way e-cigarette use is adopted

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Madurai Area Physicians Cardiovascular Health Evaluation Survey (MAPCHES)An Alarming Status