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Key factors that influence transmission risk include: Presence of active sores or lesions Viral shedding (which can occur even without visible symptoms) Moisture level on the smoking device Time between users Immune status of the recipient It's worth noting that if you smoke with someone who has herpes but doesn't have an active outbreak, the risk is lower but not eliminated, as asymptomatic viral shedding can occur

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In 2021, among 12th grade students, 1.9% reported smoking flavored little cigars in the past 30 days