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While possible changes in unrecorded tobacco supply are yet to be considered to determine changes in population level tobacco use, an upward trend would constitute a severe setback in reaching global goals to reduce smoking prevalence [51] and the attributable burden, both of which remain high in the European region [52, 53]

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Nicotine also has a negative impact on brain development in adolescents, according to the Surgeon General

However, realistic plans must also be taken into account that sustained cessation may not be achievable for many smokers, and alternative options should then be offered