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We should note here that cohort-specific cigarette consumption varies greatly from state to state due to, in part, the differences in state-level tobacco control policies such as cigarette taxes and smoke-free air laws, as well as social norms and sociodemographic composition 58

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As for whether an increase in e-cigarette use has perhaps led to a decrease in use of other tobacco products, Krech said that WHO could not at this time say whether that has an impact or not. However, he acknowledged that many tobacco smokers are so-called dual-users using both combustible cigarettes and e-cigarettes