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"RAI is committed to promoting tobacco harm reduction, in other words, identifying consumer-acceptable tobacco products that may present less harm than conventional tobacco-burning cigarettes." Altria, which owns Philip Morris USA, the maker of Marlboro cigarettes, said in a separate emailed statement that the company "will carefully review the proposed rule and its implications to our businesses and submit comments." More than 40 million adults in the United States still smoke cigarettes, according to the CDC, and about 4.7 million middle and high school students use at least one type of tobacco product, including e-cigarettes.

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The child will most likely have X rays performed prior to decisions about a treatment plan

76 Remy and Cafardo: 225

however, with the prevalence of nicotine use in the population it should be considered a comorbidity for future microbiome and behavioral studies