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Thats nearly double the burden faced by households in Utah, the most affordable state in the ranking

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More recently, the prevalence of youth use of smokeless tobacco products has risen (0.9% in 2021 to 1.3% in 2022) as has youth use of oral nicotine pouches (0.8% in 2021 to 1.1% in 2022) according to annual NYTS data

Compared with cigarettes, cigars have more toxins, including ammonia, cadmium, and tar