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In fact, a recent NACCHO survey of rural local health departments notes that 93 % of respondents see e-cigarettes as a public health threat in their community. However, our research also notes that there are real barriers to ensuring that cessation and prevention activities are available in all communities, we urge the administration to work swiftly to adopt this and other measures to address the youth vaping crisis and to support local communities in addressing tobacco use across the board.