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Vapes can be used quickly and often without detection since little residual odor results from vaping, and they are usually small and easily disguised

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Table 2 Mental health service utilisation and patient satisfaction levels

As the conflicting numbers suggest, rising taxes have helped turn black-market cigarettes into a problem that defies easy measurement, and one hard to solve simply by saying stop. For voters and state officials, its growth forces the question of how we weigh the social benefits of increased cigarette taxes against the mounting costs of the opportunities they create outside the law