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(2) environmental factors that may increase the opportunity, willingness, or interest to use both products (e.g., low monitoring of youth by parents, use of tobacco products by peers or family, permissiveness of tobacco product use by peers or family, exposure to tobacco product advertising)

Frequent exacerbators have a poor prognosis, so identifying them and preventing further flare-ups is a major concern

These trends are likely the result of the escalating tobacco control measures imposed on tobacco firms and are expected to continue

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