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In North Carolina, the adult tobacco use rate was 27.1% in 2019, as reported by the American Lung Association (2020) in the State of Tobacco Control. The state has struggled to reduce tobacco use, earning failing grades in efforts to prevent smoking and e-cigarette use

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The cigalike is the most common starting place for long-term cigarette users, mainly because they represent excellent value for money, are simple to assemble and have the look and feel of a cigarette