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The use of e-cigarettes is prohibited at childcare homes and centers, in residential child care facilities, in licensed pediatric extended care transportation vehicles, and in foster homes.9 Licensing laws Retailers and wholesalers are required to obtain a license to sell tobacco products.6 A license is required to sell e-cigarette products.9 Youth access laws In December 2019, the United States adopted a law raising the federal minimum age of sale of all tobacco products to 21, effective immediately

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Furthermore, smoking induces several molecular changes, including epigenetic modifications, such as DNA methylation and histone modifications, which can alter the expression of genes involved in immune responses and mucosal integrity