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Smoking any cigarette including non-tobacco cigarettes creates carbon monoxide, which is known to the state of California to cause cancer and reproductive harm

The price of cigarettes has been rising consistently in the US since 2018, because of growing taxes and restrictive laws

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Cultural norms further undermined adherence, with some students describing smoking a normalized social activity

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The Global Burden of Disease Study calculates that in 2016 there were an estimated 6.3 million smoking-related deaths annually: 884,000 from second-hand smoke, and 48,000 from oral tobacco (none of which were related to snus)