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Preclinical mouse models have confirmed that e-cigarettes increase the infectivity of Pseudomonas aeruginosa , Streptococcus pneumoniae , Staphylococcus aureus , human rhinovirus (HRV), and respiratory syncytial virus (RSV) [42, 47]

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While cigarette sales have been gradually declining for more than a decade, the country still has the highest rate of tobacco use in the Western Hemisphere

However, if this is not possible, then I recommend that patients cut down to half the amount they are smoking