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In total, 403 students participated in the study, of which 64.6% (93 students) were diagnosed with GERD, 23.1% smoked tobacco and 43.7% vaped electronic cigarettes

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Middle and High School Students National Youth Tobacco Survey, 2023 Vital Signs: Tobacco Product Use Among Middle and High School Students United States, 20112018 Trends in Current Electronic Cigarette Use Among Youths by Age, Sex, and Race and Ethnicity Tobacco Product Use Among Adults United States, 2021 Balancing Consideration of the Risks and Benefits of E-Cigarettes

The question of whether a states share of lottery proceeds constitutes a sin tax is debatable, but the Tax Foundation, a national tax policy research organization, maintains that if a states intent in offering a lottery is to raise revenues for the state as in Texas, where net lottery proceeds support public education the payment is a tax