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[62] An officer with the North Carolina Department of Public Safety described the conflicting laws: "We're in limbo trying to figure out what we can and cannot do," [63] As of January 2026, North Carolina Alcohol Law Enforcement does not enforce the federal law

It causes: lung disease including emphysema and chronic bronchitis heart and circulatory disease including heart attack, stroke and narrowing of the arteries at least 15 types of cancer including lung, mouth, throat, stomach, liver, kidney, bowel, bladder and cervix Reduced fertility in both men and women Smoking can cause bones to become weak and brittle, increasing the risk of osteoporosis in women

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