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Tobacco is now one of the most heavily taxed consumer products in the country, and the aim is clear: to make smoking less affordable and reduce the number of people who smoke
The decline has been driven by tightening tobacco regulations, higher excise taxes, and a growing shift among adult consumers toward reduced-risk products such as heated tobacco, vapor devices, and oral nicotine pouches
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In these circumstances, marginal structural models can be used to estimate controlled direct effects (CDEs) [38, 39] within strata of smoking (assuming no unmeasured confounding)
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