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Although this testing method is not as common, hair follicle tests are highly effective in identifying long-term nicotine usage

In 2005, Needham, Massachusetts was the first town in the US to enact a law raising the MLSA to 21

The nicotine patch demonstrates comparable effectiveness compared to other NRTs such as gum, lozenges, sprays, and inhalers
The high persistence is explained in part by deep-rooted cultural practices involving traditional forms of tobacco use, by regulatory policies that are inconsistently enforced, together with limited access to cessation services (2224)

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