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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

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First, ICD criteria require that the symptoms "should have occurred together for at least 1 month or, if persisting for periods of less than 1 month, should have occurred together repeatedly within a 12-month period" [37], so how could the diagnosis be made 13 days following the first inhalation

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