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Active maternal smoking was assessed using self-reported questionnaires that specifically asked whether the mother used any tobacco or nicotine products during the ECHO index pregnancy

Vaping involves the use of a handheld electronic device, such as an e-cigarette or vape pen, which heats a liquid to create an aerosol mist that users inhale into their lungs

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The most frequently occurring, the report said, were related to the active shooters mental health, problematic interpersonal interactions, and openly communicating violent intent. It went on to say that, in the majority of cases, shooters obtained their firearms legally, and at least one of the victims was specifically targeted. Red flag laws are a backstop, designed to fill gaps in the system