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In 2011, the IOM issued a further report (Institute of Medicine2011) on the science needed to assess such products, which it identified as "modified-risk tobacco products" or MRTPs

They acknowledge vaping is likely less harmful but emphasize that "less harmful" doesn't mean "harmless," and they warn against using vapes as a gateway product for non-smokers

The problem is that there is no current way to be sure exactly what is in an e-liquid, and no official certification scheme to guarantee that a label claim is accurate

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