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Pipe smokers are at a higher rate for lip cancer, and cigar smokers are four to 10 times more likely to develop life-threatening oral cancer, esophageal cancer, and laryngeal cancer

States like Kentucky, West Virginia, and Tennessee, where smoking prevalence is highest, also report the nations greatest rates of sleep insufficiency and mood disorders

And adding legal marijuana to the picture "only makes it a more complicated issue," says Erika Sward, an assistant vice president