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Continued surveillance of youth e-cigarette use is needed, especially considering that use patterns continue to change with the evolving product market

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Key factors that influence transmission risk include: Presence of active sores or lesions Viral shedding (which can occur even without visible symptoms) Moisture level on the smoking device Time between users Immune status of the recipient It's worth noting that if you smoke with someone who has herpes but doesn't have an active outbreak, the risk is lower but not eliminated, as asymptomatic viral shedding can occur

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