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Although nicotine levels vary significantly across the spectrum of types, the fact remains that nicotine use during adolescence has been shown to impact learning, attention span and proneness to addiction

This economic substitution effect should be considered in tobacco policy along with where each product falls on the risk continuum so that cigarette and ENDS regulations are coordinated to disincentivize combustible tobacco use

The tobacco is either kept whole or crumbled and burned as part of the ritual, often accompanied by personal prayers and requests for guidance or protection