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However, some states, such as Alaska, Arizona, and North Carolina, allow smoking at a younger age, typically less than 21 years old

Instead, they offer a legal, structured pathway to care: assessment by qualified professionals, diagnosis, shared decisionmaking, and, when clinically appropriate, a legitimate prescription or supervised longacting injection program

It was after the Report came out, which then I think put the Surgeon Generals office in the cross hairs of the politically powerful tobacco industry during the Johnson administration, that the office was downgraded, and they created a thing called the office of the Assistant Secretary of Health and made the Surgeon General an advisor to the office of the Assistant Secretary for Healthand no longer in charge of the Public Health Service

Raising the federal minimum age for tobacco sales (and similar products) from 18 to 21 years old didnt deter 18-year-olds from carrying on with the vaping trend