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In long-term or heavy use, reported issues include addiction (risk is 9% overall, but 17% for those who start use in adolescence, and up to 50% in those who are daily users), altered brain development, poor educational completion/outcomes, cognitive impairment (IQ levels impaired with frequent use during adolescence), diminished long-term life satisfaction, increased risk of psychotic disorders such as schizophrenia

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The Food and Drug Administration only gained authority over the tobacco industry in 2009 with the Family Smoking Prevention and Tobacco Control Act