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Tobacco use weakens the lower esophageal sphincter, increases stomach acid production, and impairs the esophaguss natural ability to clear acid, creating a perfect storm for persistent and worsening reflux symptoms

With more states legalizing the drug, it has become the most commonly used drug that is still illegal at a federal level

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Further tax increases may compensate for some of these losses in absolute terms, however, it is likely that this will also contribute to growing demand for cheaper illicit tobacco