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The specialty clinic changed its processes to ensure patients were screened for tobacco use before seeing providers

At the same time, studies have shown a crossover between marijuana and tobacco use

Youth are smoking flavored little cigars (1.5%) at rates lower or equivalent than cigarettes (2.3%), regular little cigars (1.3%), or large cigars (1.5%)

As a consequence, our findings give insight into the practice of a highly accomplished expert in this field, but a broader, cross-ethnic interview study would be needed to know if they are representative of Peruvian-Amazonian tobacco uses in a more general sense