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After years of fighting a losing battle against the state over the taxation of name-brand cigarettes sold on reservations, many are now making their own cigarettes

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The question of whether Juul can be a stepping stone to traditional smoking remains open, but there is some doubt about this, based on recent evidence that youth smoking rates are steadily declining (the proportion of American teenagers who smoked in the last 30 days decreased from 28.3% in 1996 to 5.9% in 2016)