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This piece was produced by SciDev.Nets Asia & Pacific desk.

According to the October 4, 1889, edition of the Monroe Daily Independent physicians studying the proliferation of smoking in locations such as San Francisco, California and Denver, Colorado determined that tobacco should be used moderately, if used at all. The four doctors involved in the study concluded that laborers and artisans could smoke all they want without injury, but that brain-workers exposed themselves to the risk of nervous collapse if they indulged in more than one cigarette a day

PMID 29325111

While the South consistently leads the nation in smokeless-tobacco use, the West is close behind especially the rural West, where use is nearly four times the national average