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This slight increase trends against the national figures, where sales in 2020 were projected to decline around 2 percent

Black youth have lower rates of cigarette smoking than other groups

In a systematic review including 21 studies 35 , patients who smoked had a significantly lower clinical pregnancy rate per cycle (OR 0.56, 95%CI: 0.430.73) and a significantly higher spontaneous miscarriage rate (OR 2.65, 95%CI: 1.335.30)