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Long-term smoking leads to more serious problems, including gum disease, tooth loss, and even oral cancer
If a product cannot be sold at a store in Orange County, it cannot legally be shipped to an Orange County address either

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This highnicotine tobacco and the prevalence of kretek smoking among farmers create a distinctive health dynamic in the village, where nicotine tolerance alters the pattern of GTS symptoms compared to non-smoking populations
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It is also encouraging that initiation of tobacco products, including cigarettes, has been declining among youth and young adults with a significantly lower percentage of individuals ages 12 to 24 reporting smoking initiation in 2018 compared with 2008 (129)

While the observed patterns across different demographic subgroups reinforce the robustness of our results, further studies are needed to validate these findings across various global populations to enhance the universality of our conclusions
