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Also, we excluded participants who reported using cigars as blunts every time they smoked a cigar in the past 12 months, given that blunts do not meet this papers definition of a cigar (i.e., a tobacco roll wrapped in either tobacco leaf or another tobacco-containing substance) [2] and are likely to be used differently than cigars (e.g., because of differences in accesss to and legality of marijuana)

Most manufacturers add a buttery flavoring called diacetyl to their recipe

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Results A total of 3 129 259 pregnant individuals were included (mean [SD] maternal age 29.3 [6.0] years), of whom 23 007 (0.7%) had a cannabis-related diagnosis, 56 811 (1.8%) had a nicotine-use diagnosis, and 10 312 (0.3%) had both in pregnancy