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[50] According to research on alcoholism in Native American populations, "the problem of alcohol abuse is now defined as one that is both foreign to and destructive of the traditional culture" [51] Native American youth show higher rates of drinking and drug use than most other racial or ethnic groups and those that live on reservations are at the highest risk of developing alcohol related problems

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The place with the highest lifetime cost of smoking is the District of Columbia, at just under $5.9 million when factoring in out-of-pocket costs, lost investment opportunity, income reduction, and increased medical expenses