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Inability to stop using tobacco products, despite making attempts to quit Continuing using tobacco products despite health problems Strong cravings for tobacco Withdrawal symptoms when trying to quit Giving up activities or refusing to attend events/places where tobacco use is not allowed Using tobacco products to deal with stress or feel normal Gradually increasing tobacco use Spending most of the time during the day using tobacco products, at home, work, and other places Tobacco products are legal, easily obtained, and people can consume them in public

To view a copy of this licence, visit About this article Cite this article Gibson, P.B., Rampal, N., Goddard, F.W

Withdrawal symptoms such as irritability, restlessness, and difficulty concentrating when trying to quit smoking

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Other variables The following data were collected as confounding variables: age, sex, education level ( elementary school, middle school, high school, or college), household income (quartile), alcohol intake (drinking alcohol at least once a month), adequate aerobic physical activity (moderate physical activity 150 min/week or vigorous physical activity 75 min/week), obesity status (body mass index 25 kg/m 2 ), and comorbidities (defined by questionnaires regarding doctor-diagnosed chronic diseases such as hypertension, diabetes, or dyslipidemia) 17,18

As we learned about the mistakes of past generations, we watched them repeat themselves in real time