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Less is known about the relationship between vaping and smoking among individuals with moderate levels of psychological distress (MPD), a group whose members may not experience serious mental illness but still endorse higher rates of mental healthcare utilization, impairment, substance use, and other risks compared to those with no/low psychological distress 24

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Indeed, health promotion and disease prevention cannot have been less valuable or secondary to treatment for controlling the spread of CVD since both are two sides of the same coin, complementing and reinforcing each other, along a continuum of interventions