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The seroprevalence rate was 13.8% in hookah and cigarette smokers, 9% in cigarette smokers and 1.1% in hookah smokers exclusively ( Figure 1 ), and was a highest rate in the age groups 2130 and 3140 years with 12.80% and 7.40% respectively ( Figure 2 )

The Nevada Tobacco Control Program and our Partner Coalitions and Health Districts have made working with commercial tobacco retailers a priority. The DPBH also says, A free training and certification program has been developed and updated with the newest guidelines provided by the Federal Food and Drug Administration (FDA), which provides essential education through a set of Learning Modules and concludes with a certification quiz. According to the division, Every retail clerk, supervisor, manager, and business owner who completes the training and quiz becomes a State of Nevada Certified Responsible Tobacco Retailer. The agency adds that certification carries added responsibility and understanding, stating, Becoming a Certified Responsible Tobacco Retailer in Nevada means you have acquired the knowledge and understanding of the importance in keeping nicotine-derived products like commercial cigarettes, cigars, dissolvables, hookah tobacco, nicotine gels, pipe tobacco, roll-your-own tobacco, smokeless tobacco like Dip, Snuff, Snus and chewing tobacco, vapes, e-cigarettes, hookah pens and other Electronic Nicotine Delivery System (ENDS) including e-juices and flavors, out of the hand of youth. It also notes, You understand the likely health effects associated with nicotine-derived tobacco products on youth, including how it affects the developing brain of youth

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