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Mazzone explains, are simply too high. This flies in the face of two pivotal clinical trials, reported in the New England Journal of Medicine, documenting that vapor works for smoking cessation (here and here)

Value (USD Billion) [2020-2033] 7.12.3 MEA Menthol Cigarette Market by Application

Per CDC's 2019 Behavioral Risk Factor Surveillance System (explained in the article below), West Virginia had the highest rate of smoking in the country, at 23.8 %, followed by Kentucky, Louisiana, Ohio, Mississippi, Alabama, Arkansas, Tennessee, Missouri, Indiana, Oklahoma, and Michigan.

Workers at Tobacco Road Pumping Station said that sewage was being pumped into the sea