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According to the 2023 National Survey on Drug Use and Health (NSDUH) conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 22.7% of individuals aged 12 or older in the United States used tobacco products or vaped nicotine in the past month, equating to about 64.4 million people

Third, we adjusted for a comprehensive set of confounders spanning demographic, socioeconomic, clinical, and behavioural domains