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Competing interests: One of the co-authors, Alan Mathios, has received support on another project related to e-cigarettes which is funded by a grant to Cornell University from the Foundation for a Smoke Free World

On the other hand, successfully quitting smoking is associated with improvements in mental health. The review found that depressed smokers first adverse state while trying to quit is a combination of low positive affect (low pleasure and engagement in rewarding activities, such as socializing or physical activity) and high negative affect (feelings of anger, sadness, guilt or anxiety)

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We recommend the CDC provide a simple definition of these products