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doi: 10.1016/j.molcel.2017.10.022

A 2018 report by the National Academies of Science, Engineering and Medicine (NASEM) found the effect of e-cigarette use on cigarette smoking initiation to be causal, concluding, "There is substantial evidence that e-cigarette use increases risk of ever using combustible tobacco cigarettes among youth and young adults." A July 2021 report issued by the World Health Organization (WHO) concluded that youth who use e-cigarettes are more than twice as likely to go on to smoking cigarettes

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The foundation was also active in litigation concerning federal drug possession laws, and it had a grant program to support reformminded research centers, needle exchange programs, and harm reduction groups