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In North Carolina, the adult tobacco use rate was 27.1% in 2019, as reported by the American Lung Association (2020) in the State of Tobacco Control. The state has struggled to reduce tobacco use, earning failing grades in efforts to prevent smoking and e-cigarette use

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Until we address the root cause of this condition, then this may make it very challenging for a patient to make permanent, healthy changes to their diet

The blending process for manufacturing the most popular bidi brands is a closely- guarded secret, but is roughly done by mixing different grades of tobacco and wrapping them in a leaf called the tendu

Contact your local flight surgeon for support and assistance