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In fact, the study researchers confirmed that limitations of the study include that cross-border or online cigarette sales in Massachusetts were not accounted for. This admission by the study authors raises the question whether excluding changes in cigarette sales in adjacent states, specifically New Hampshire, Rhode Island and Vermont, was a choice to support their eventual claim that a statewide menthol cigarette sales ban is associated with a significant decline in all cigarette sales to residents of the subject state

Additionally, consistent use of tobacco by patients with some health disorders may dampen their motivation to quit and reduce their adherence to tobacco cessation interventions