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Annually, over 8 million people die from tobacco-related causes, including around 1.2 million non-smokers exposed to second-hand smoke

Its the mindful application of flame, the first fragrant wisps of smoke, and the settling into a personal rhythm of breath and contemplation

The data in subsequent years may capture changes in smoking and vaping attitudes and behaviours that are causally related to the pandemic or lockdown

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Proactive outreach and populationlevel or universal offers of tobacco treatment may mitigate some of rural (and Appalachian) residents foremost barriers to engaging in treatment, as challenges with asking for help with a sensitive or stigmatized problem, scheduling appointments and finding suitable providers are inherently addressed at the system-level and the importance of cessation is clearly communicated by healthcare providers 30