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The prevalence of smoking before pregnancy ranged from 3.5% in Puerto Rico to 20.2% in West Virginia

Cessation needs to be system-embedded with focus on population-level strategies such as quit lines, mCessation and brief advice integration into primary health care and state programs

Patients were eligible if they had a diagnosis of T2DM and TUD, had health care utilization between December 2017 and March 2023, did not use antidiabetes medications in the past 12 months, and had at least one disease on the prescription guideline for semaglutide

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