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Previous research using the K6 scale [4143] has used the highest band of the scale, scores of 13 and above, to define the category of serious psychological distress, which is highly correlated with severe mental disorder requiring clinical care [28, 29]

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Research indicates that once a teen starts vaping, they become over 30 percent more likely to transition to smoking traditional forms of tobacco, such as cigarettes, cigars and hookahs