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Cigarette smoking is the principal cause, although long-term exposure to other lung irritants (including air pollution) also contributes

As of January 2026, you can smoke on caf terraces, on streets (away from schools and bus stops), and in private spaces

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A Surgeon General report said menthol products increase addiction and are "disproportionately used by Black people, Native Hawaiian and Pacific Islander people, women and people who identify as lesbian, gay, or bisexual." A ban would have likely cost billions of dollars in annual revenue for cigarette companies such as Altria and British American Tobacco