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The decline in the States is in part due to aggressive anti-smoking public service campaigns that aren't as common in China, where "the belief that protective biological mechanisms specific to Asian populations make smoking less hazardous, that it is easy to quit smoking, and that tobacco use is an intrinsic and ancient part of Chinese culture" are widely accepted as true, the study reports

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Yes, this electric Cigarette is not for smoking, not mass produced, and not affordable for most people

Forest plot for VTE incidence: risk estimates for former versus never smokers

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However, some carriers have exceptions as noted below: The use of electronic cigarettes / vape will also classify you as a tobacco user if the electronic cigarette contains nicotine