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While cannabis is widely grown in Sierra Leone, the fentanyl is thought to originate in clandestine laboratories in China, where the drug is manufactured illegally and shipped to West Africa

Between 2017 and 2022, average nicotine concentration increased from below 2% to 5% in what has been dubbed the nicotine strength arms race. This trend of increasing nicotine strengths places youth at greater risk of addiction, lower motivation to quit, and amplified symptoms of anxiety and depression

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