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New products and new challenges Faced with declines in cigarette use the youth smoking rate dropped from nearly 23% in 2000 to around 2% today the commercial tobacco industry has expanded its product offerings to include flashy e-cigarettes and flavored nicotine products such as oral nicotine pouches, dramatically changing the product landscape and raising concerns about products that appeal to young people

For more information on the importance of Tobacco 21, see this article from Kansas City Medicine by Bridget McCandless, MD, MBA, retiring president of the Health Forward Foundation and a past president of KCMS.

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However, this lack of a state law does not mean it is without risk

exported $10 million worth of tobacco to Vietnam in 2016, an increase of more than 250 percent compared with shipments in 2012, according to the U.S