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While cannabis is widely grown in Sierra Leone, the fentanyl is thought to originate in clandestine laboratories in China, where the drug is manufactured illegally and shipped to West Africa

Importantly, our review incorporates the most recent literature, including large-scale longitudinal studies, systematic reviews, and MR analyses recently published, thereby offering a timely reassessment of the pulmonary and oncological consequences of cannabis in the context of increasing legalization, higher product potency, and evolving consumption patterns

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[9] A majority of adolescents and young adults are exposed to cigarillo advertising in magazines and storefronts and on social media