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A major limitation is that we cannot determine the true sensitivity or specificity of Medicare data for diagnostic coding of tobacco use

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In contrast to cigarettes, where many consumers remain loyal to one brand/flavor for a lifetime, many vapers regularly change the flavor of their liquid

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The researchers also looked at health outcomes by how often someone reported using e-cigarettes, either daily or some days. When compared to non-e-cigarette users, daily e-cigarette users had higher odds of heart attack, coronary artery disease and depression/anxiety, whereas some days users were more likely to have a heart attack and suffer from depression/anxiety, with only a trend toward coronary artery disease