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Prevention programs should also target expectant mothers and parents, as smoking during pregnancy increases the risk of adverse neonatal outcomes, and parental smoking remains a strong predictor of later tobacco use in children ( As children transition into adolescence, parental influence diminishes while peer pressure and social conformity gain importance

The Family Smoking Prevention and Tobacco Control Act of 2009 set a national minimum age of 18 for tobacco sales and purchases, and three states have gone further, setting the age for cigarette purchasing at 19

However, more serious drug-related issues have arisen