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Many studies try to avoid including participants with comorbidities in things like substance use, and even psychiatric conditions like anxiety and depression, in order to avoid confounding results

Bishop-Kelly said Hyland pointed to Needham, Mass., which raised its smoking age to 21 in 2005, and where youth smoking had shown a dramatic decline, averaging 56 percent in middle school and 70 percent at the high school level, since the age hike