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Then, the overall risk of bias of each included study was evaluated as either: low (all criteria were of low risk), unclear (at least one criterion was evaluated to be of unclear risk but no criterion of high risk), or high (at least one criterion with high risk of bias)

Because of this tax structure, native smokes: Often exclude some or all of the usual tobacco taxes Are sold through independent, Indigenous-controlled distribution networks Frequently sell at prices that are far below fully taxed retail brands Despite a persistent myth that theyre knock-offs, many First Nations tobacco companies maintain strict manufacturing standards, using Canadian-grown tobacco and modern rolling/packaging lines

The focused outreach has been highly effective, particularly among the Black community

As changing puffing behaviors might be unconscious, vapers should exercise caution when transitioning to lower nicotine concentrations