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A variety of factors contribute to these regional and state-by-state disparities

People who already smoke have a level of nicotine to which they have become accustomed

However, even the Surgeon General has issued a warning that some e-liquids, especially the flavored varieties, contain diacetyl, a harmful chemical that can lead to lung disease and even second-hand vaping can cause health problems

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As a result, both government (local, state and federal) and private funding of tobacco control efforts have languished or re-directed elsewhere