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The geographical isolation of many reservations create logistical and cost challenges, limiting people's ability to access affordable nutritious food because they live far from large grocery stores

Our study showed that smoking initiation and lifetime smoking may causally increase abdominal adiposity, as indicated by higher waist to hip ratio While we found no evidence of an association between smoking heaviness and abdominal fat distribution, our reverse causal analysis indicated that higher abdominal adiposity may causally increase smoking heaviness, the study authors wrote

This legislation (known as Tobacco 21 or T21) became effective immediately, and since then it has been illegal for a retailer to sell any tobacco product, including e-cigarettes, to anyone under 21

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