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By the 1960s and 1970s, cigarettes had become shorthand for independence and modernity

We based our recommendations on an overview of Cochrane reviews on smoking cessation interventions;22 certainty of effects is described in Appendix 1, available at www.cmaj.ca/lookup/doi/10.1503/cmaj.241584/tab-related-content

We hypothesized that more frequent vaping would be associated with lower daily cigarette consumption and that this association would be stronger among those with increased psychological distress

It is underpinned by the concept of the hard-core smoker as someone who is stubbornly resistant to population tobacco-control initiatives