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That shift, combined with the rise in pouch popularity, led me to gradually shift over to pouches. Althoff, whos in her 20s, said there was a very noticeable culture shift among women in her generationthat younger women were skipping the smoking stage of peer pressure altogether, and moving straight to pouches

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Conclusions Our findings highlight strong social influences on girls perceptions, exposure to opportunities, and decision-making in ways that can often be protective against smoking, particularly at younger ages, but may also leave girls unprepared to manage challenging situations later in life