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A 2021 JAMA Pediatrics research letter analyzing youth smoking rates following the ban on sales of flavored tobacco products in San Francisco, California, surprisingly concluded that the ban was associated with increased smoking among high school students under the age of 18 relative to other school districts

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The decision to raise the smoking age was not necessarily grounded in a unified theory of legal adulthood, but rather in what was politically achievable in a specific area of public health policy