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Further, the PACT Act limits the ability of states and local governments to regulate the delivery carriers involved in remote salescomplicating enforcement effortsand did not place such restrictions on other tobacco products, such as ENDS

To replace M51.36, the new codes are: M51.360 (other intervertebral disc degeneration, lumbar region with discogenic back pain only)

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As mentioned above, the impact of cigarette smoke on these pathways can lead to intestinal inflammation, impaired ileal barrier, and alterations in bacterial clearance (12, 19)

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