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Instead, strong tobacco policies in Tobacco Nation have failed to gain traction due to a combination of lack of political will to prioritize strong policies, tobacco industry interference in legislation, and state tobacco policies undercutting stronger local policies

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Several studies found that in 2019, when the EVALI outbreak occurred, and the years following the outbreak, participants perceived safety of e-cigarettes decreased while their perceived harm of e-cigarettes increased [18, 26, 28]

The letters did not order Reynolds to recall its products, or explicitly threaten any fines or legal action against the company, but the notice could drastically cut into Reynolds sales because it would open up retailers to fines if they sell the products