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Even more startling, research shows an increase in middle schoolers using e-cigarettes, with the use among these children up 48 percent from 2017 to 2018

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Stanford Medicines Tobacco Prevention Toolkit American Heart Association: Youth Tobacco and Vaping Resources for Educators, Administrators, Parents, Students, Counselors, and Health Professionals Reinforcing Social Emotional Learning (SEL) techniques like high self-esteem, parental involvement, school involvement, athletics, and positive role models provide students with the tools needed to resist peer pressure