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ECs have also become the most popular non-combustible tobacco products for adults, with 3.7% of adults being current EC users as of 2020.20 21 The model of ECs has further undergone several rounds of evolution over the past decade, with over 600 brands documented in the market.22 23 In 2015, nicotine salt-based ECs, most prominently JUUL pods,24 25 were introduced and its sales grew 641% from 2.2 million in 2016 to 16.2 million in 2017, taking the greatest EC market share.2628 Compared with freebase nicotine, nicotine salt products can deliver high concentrations of nicotine, thereby having great potential to be close substitutes for combustible cigarettes.2931 The rapid growth and evolution of the EC market have prompted policymakers to impose excise taxes on ECs, which has been shown to effectively reduce vaping among youth and adults.3234 The heated debate thus focuses on how to design a tax system where cigarettes and ECs are taxed relative to their harms

Breast cancer and exposure to tobacco smoke during potential windows of susceptibility