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Smoking is the leading cause of preventable death and disease in the United States, killing more than 443,000 people each year, costing $96 billion in direct medical costs and $97 billion in lost productivity, the CDC said

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And the researchers writing in the New England Journal of Medicine argue schools should emphasize zero-tolerance policies for the possession of any tobacco products on school grounds. [Juuls success] could be the first sign of a very important new category, said University of Waterloo public health researcher David Hammond