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However, the lack of data about e-cigarette use along with the mostly-unregulated nature of this market poses a major challenge in combatting e-cigarettes, the report warns

Co-use was relatively stable across the different periods. Writing in the journal of Addictive Behaviors, the researchers said that the evolving trends in use of the two substances could be evidence of a substitution effect amid changing harm perceptions, evolving legislation, and shifting norms. The rising cannabis-only use across groups parallels the expanding state-level recreational cannabis legalization, increasing accessibility and normalization, the paper says

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Smokeless tobacco use and risk of cancer of the pancreas and other organs

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