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Each of the 135 7 x 3 replica bills symbolizes $100.00the expenditure a pack-a-day smoker incurs on cigarettes in approximately 10 days

21 We now consider two distinct strategies for reshaping the market to restore law and order, support adults to quit smoking, and control youth uptake: Option 1: addressing the shadow economy primarily through enforcement Option 2: regularizing trade primarily through radically increased authorizations In practice, both will be required, but we strongly recommend focusing on Option 2 as the primary vehicle for restoring order and control to the US tobacco and nicotine marketplace

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HEALTH EFFECTS Tobacco use is associated with heart disease and cancer, the two leading causes of death among American Indian and Alaskan Native adults

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