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These communities consider traditional tobacco a symbol for peace and healing and a sacred gift of the earth and use it in medicinal and spiritual ceremonies and for instructional purposes

Hence, secondhand smoke from these cigarettes is still harmful

At the same time, it concluded that the risk of teens and young people turning to these products was low enough to not outweigh the benefits of smokers switching to them

Table 2 Perceptions to plain packaging and health warnings

Availability Native cigarettes: Primarily found on reserves or through online retailers like Gold Star Smokes, with Proof-of-Age delivery requirements