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All statistical analyses were performed using SAS V.9.4 (SAS Institute Inc., Cary, North Carolina)

Unlike sun-induced pigmentation that fades with care, nicotine discoloration goes deeper in the skin and are harder to resolve

Specifically, the proportion of middle and high school students who have ever used a cigarette in 2023 was 4.3 and 8.5 percent, respectively, equating to 510,000 middle and 1.3 million high school students (185)