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[14] In further support of these findings, the National Survey on Drug Use and Health (NSDUH) is a prominent epidemiological survey that assesses national and state-level information on alcohol, tobacco, illicit drug use, as well as mental health, in the United States

Commercial tobacco is grown, prepared, and sold in mass quantities and include thousands of extra chemicals and substances including menthol and ammonia that are not present in traditional tobacco used by people who are Native

It certainly hasn't reduced the rate because the kids can access these vapes so easily

We all know smoking isnt great for our health