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Given that cigarette butts can persist in the environment for more than a decade and continue to have negative environmental impacts throughout their lifespan [58, 103, 104], the current estimates may also underestimate the cumulative effects of cigarette butt litter
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Under that definition, anything from clove cigarettes (which have been around for decades) to nicotine-free vapes would qualify
Our findings highlighted the hazards of tobacco use for gut flora dysbiosis and shed light on the potential role of specific gut microbiota for smoking behaviors
Other commenters expressed general concerns about the potential burdens of developing and maintaining an acceptance-to-service policy, with one suggesting that CMS should reimburse HHAs for the time and effort required to develop and maintain such policies
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