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But if you go to a place like West Virginia, which has the highest smoking rate in the country, the behavior feels completely normalized," Koval says

Tuck the edge of the paper at the filter end (on the non-sticky side) over your tobacco crease

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Additionally, much of the available evidence relies on cross-sectional and observational data, which can identify associations but cannot definitively determine causality between e-cigarette use and health outcomes

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