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Noem defended her story on Friday, saying it demonstrated the harsh realities of rural life that only recently saw her family put down three horses too

A cigarette is also a smokable tobacco product

The cigars are made at the Kelner Boutique Factory in Santiago de los Caballeros, Dominican Republic, so it is no huge shock that the tobaccos used in the blend come from the Kelner familys vast library

The 4 ft 11 inches tall woman is said to have been lively and so healthy that she often bragged about never falling ill

In 2024, the health system received a HRSA grant to expand maternal health services and wraparound support for families in Butts, Spalding and Troup counties