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Although the Spanish elite first dismissed them as recycled garbage, these cigarillos, or little cigars, eventually gained popularity during the 18th century

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The widespread availability of prescription stimulants in educational and professional settings exacerbates the problem, as reported by the Substance Abuse and Mental Health Services Administration (SAMHSA) in their Prescription Drug Abuse: Executive Summary written in 2016

Funding This study was supported by National Institutes of Health grant K01-AI080974 (Brotman) and University of Maryland College Park and University of Maryland Baltimore Seed Grant (Brotman and Glover)