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These advancements have demonstrated that the respiratory tract is not devoid of microorganisms, but rather supports a complex and diverse microbiome across both the upper and lower airways [36,37,38]

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The World Health Organisation encourages member states to subject vapes and heated tobacco to heavy regulation or total prohibition

Only sales clerks are allowed access to tobacco products prior to sale, unless the tobacco products are located within the line of sight or under the control of a cashier or other employee and unless it is a retail stores which derives 75% or more of sales revenue from tobacco products.6 Local tobacco Laws Philadelphia restricts the number of tobacco retailers to one per 1,000 people in each planning district and prohibits new tobacco retailers within 500 feet of a school.10 Philadelphia prohibits the sale of all flavored e-cigarettes and the sale of cartridges or pods containing more than 20 milligrams per millimeter of nicotine, except in adult-only stores.11 Quitting statistics and benefits Quitting smoking and vaping in Pennsylvania The CDC estimates 49.7% of daily adult smokers in Pennsylvania quit smoking for one or more days in 2019.3 In 2014, the Affordable Care Act required that Medicaid programs cover all tobacco cessation medications.7** Pennsylvanias state quit line invests $1.57 per smoker, compared to the national median of $2.37.7 Pennsylvania does not have a private insurance mandate provision for cessation.7 Notes and references Notes and references Updated June 2023 * The datasets for both adults and youth prevalence were used to make direct comparisons at the state and national levels