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American Indians only had access to highly addictive and harmful commercial tobacco

While vapes generally dont contain the same harmful chemicals as cigarette smoke, they have other risks, and we just dont yet know what the health consequences of vaping over 20 to 30 years will be. One unique strength of the study is that the researchers were able to control for a wide range of other variables that are well-known to be associated with quitting, including whether they were non-daily cigarette smokers, interest in quitting (including a recent quit attempt), the presence of a smoke-free home, and socioeconomic factors

Genetics play a role

In 2024, alcohol death rates remained higher than 2019 rates for most states