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Adolescents with ever e-cigarette-only use had even higher odds of depression (aOR = 1.67, 95% CI: 1.50-1.85), anxiety (aOR = 1.48, 95% CI: 1.34-1.65), and psychological distress (aOR = 1.63, 95% CI: 1.49-1.78)

[18] For more information on tobacco and tobacco growing see: Center for Tobacco Grower Research, Who Grows Americas Tobacco, undated, International Tobacco Growers Association (ITGA), Tobacco Types, North Carolina Cooperative Extension Service, Flue-Cured Tobacco Guide (Raleigh: North Carolina Cooperative Extension Service, 2013), University of Tennessee Institute of Agriculture and University of Kentucky College of Agriculture, 2013-2014 Kentucky & Tennessee Tobacco Production Guide (Lexington: University of Kentucky Cooperative Extension, 2013), (all accessed November 13, 2013)

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"Tobacco Facts Why is Tobacco So Addictive?"

Age verification for retailers can alleviate these challenges by providing clear guidance