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Those figures are down from 22.3% (or 45.8 million) in 2002, though smoking prevalence has hovered around 20% for the past several years

Nicotine remains cardiotoxic even when its included in vapes, and inhaling the wrong vape product can lead to serious conditions like lipoid pneumonia

A sizable literature of peer-reviewed academic studies supports these observations.[11] A 2017 study published in Public Finance Review provides the academic theory and estimates for how tax rates affect smuggling, highlighting that easily transportable goods (e.g., cigarettes) will be attractive cross-border shopping items.[12] A 2018 study published in the same journal supported those findings by examining littered packs of cigarettes across 132 communities in 38 states, finding that 21 percent of packs did not have proper local stamps.[13] In addition to high taxes, the study found that bans on flavored cigarettes in Massachusetts and California have sent smuggling to new heights

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