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Overall, ENDS likely confer lower individual health risk compared to continued smoking, but impacts on youth uptake, dual-use, and implications for population health outcomes need ongoing investigation (Sala and Gotti 2023)

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Table 1 shows that outbound smuggling increased by 26.4 percentage points in Delaware, roughly $19 million worth of revenue for the First State, moving Delaware down six spots in the ranking of states by net inbound smuggling