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E-cigarette use among teens who already smoke early in adolescence generates more harmful patterns of tobacco use later on in adolescence, said lead researcher Brian Kelly, from the department of sociology at Purdue University, in West Lafayette, Ind

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They take bigger puffs, they take deeper puffs, they take longer puffs, they smoke more cigarettes per day to get the amount of nicotine they are seeking to satisfy their addiction, said David Burns, a retired medical professor at the University of California, San Diego, who edited some of the Surgeon Generals reports on smoking

Urine tests are the most widely used, non-invasive test for identifying nicotine and its metabolite cotinine