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While excessive drinking has been somewhat pacified on social media or even in real-life social settings, drinking can be deceptively dangerous, and binge drinking is particularly troubling

Despite enormous progress in reducing smoking, tobacco use remains the leading cause of preventable disease and death in the United States killing more than 490,000 people and costing the nation over $600 billion in health care expenses and lost productivity each year

Nicotine equivalency was determined by quantifying serum cotinine levels (a nicotine metabolite) in blood samples collected 30 min post-exposure

Smoking or vaping typically lasts 2 to 4 hours, with effects peaking in the first 30 minutes

The authors wish to thank the members of the University of California San Francisco Writers Task Force for their helpful comments on the manuscript

Im also deeply disturbed that a single pharmacy chain racked up almost 1,800 violations for selling tobacco products to minors across the country. About a dozen states in addition to hundreds of cities have raised the tobacco-buying age to 21, according to The New York Times