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The connecting element is as much the struggle and hardships as the successes these farmers have with tobacco

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A study published in Pediatrics looked at cigarette use over a 20-year period by Southern California 11th- and 12th-graders and found that e-cigarettes were recruiting a new group of users who would not likely have initiated combustible tobacco product use in the absence of e-cigarettes. Another study showed that teens using flavored versions were less likely to see tobacco smoking as dangerous and therefore more likely to take up cigarette smoking

In 2018, Twain was announced as the second recipient of the CCMA Generation Award

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