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The decision to raise the smoking age was not necessarily grounded in a unified theory of legal adulthood, but rather in what was politically achievable in a specific area of public health policy

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Third, although we evaluated the potential for publication bias in the data, we did not test for other forms of bias such as when studies are more consistent with each other than expected by chance 29

South Dakota raised the smoking age to 21 in 2021 to align with federal law