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In addition, several studies have found that socio-economic factors, such as education, wealth, and age, as well as cultural norms, also play a significant role in determining the consumption of alcohol and tobacco, for which behaviour change interventions are warranted [29, 32, 33]

It is produced from a dried and shredded tobacco, along with herbs, leaves and bark

Unfortunately, these figures align with the rapidly increasing numbers of middle and high school students using e-cigarettes, with numbers rising from 3.6 million in 2018 to 5.4 million in 2019a difference of about 1.8 million youth

Nationally, the smokeless tobacco use prevalence among high school students was 2.5%