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That, coupled with the finding from this study of a modest decline in current use among young adults aged 18 to 20 years, might be an early indication that recently implemented federal and state policies, including the Tobacco-21 legislation and e-cigarette flavor restrictions, could be having an effect, said study co-author Ellen Boakye, M.D., M.P.H., a research fellow at Johns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease