An additional feature of e-cigarettes that is now often manipulated is nicotine type, based on the ratio of the R- and S-nicotine isomers: synthetic nicotine contains a mixture of both R- and S-nicotine, whereas traditional tobacco-derived nicotine contains primarily S-nicotine 15
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These come in the form of patches, gums, sprays and lozenges for easy and convenient nicotine delivery
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In our 2017 report, Tobacco Nation: The deadly state of smoking disparity in the U.S., we highlighted a group of 12 states in this region, all of which had higher smoking prevalence than the national average: Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Oklahoma, Tennessee and West Virginia
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