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The variation in cancer rates among states can also reflect poverty, environmental health, and different screening practices, which may lead to under- or over-reported rates of disease.

Effect of maternal smoking cessation before and during early pregnancy on fetal and childhood growth

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However, some studies that tracked populations of young people over time found that increased e-cigarette use was associated with lower smoking rates across populations. Some also found that as youth vaping decreased, subsequent youth smoking went up, she said