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But when researchers only considered people who quit cigarettes as of 2013, former smokers were not more likely to relapse if they vaped. The researchers noted in their study that "measures of plasma nicotine levels have shown that, compared with older models of [e-cigarettes], the new generation delivers higher levels of nicotine to the bloodstream," which may make them more satisfying. Other "technical improvements in [e-cigarettes] over time," they said, may also explain why people who recently quit smoking and switched to e-cigarettes were less likely to relapse than those who quit earlier. The ten-item Penn State Dependence Index (PSDI) suggested greater dependence on smoking than vaping The most common reasons for vaping were to reduce smoking (79%), enjoyment of flavors (78%), and ability to vape where smoking is not allowed (73%)

Tobacco also creates hefty intangible costs, which makes up the majority of the $136.9 billion