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Recommendation 39: State tobacco control agencies should conduct surveillance of tobacco sales and use and the effects of tobacco control interventions, in order to assess local trends in usage patterns

Some studies suggest that heavy use can affect motivation

Upper airway obstruction has been observed in rare instances where the patient received greater than the recommended dose and was excessively sleepy and difficult to arouse (see WARNINGS and ADVERSE REACTIONS)

Global Perspectives and Regional Preferences Tobacco preferences vary dramatically by geography and culture

Alternatively, e-vapor products heat an e-liquid to release nicotine and flavors, while also avoiding combustion and smoke