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Robin Deterding, chief of pediatric pulmonary medicine at Childrens Hospital Colorado, during a rally at Denvers city hall

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72 An editorial 73 in the American Journal of Public Health considered ways in which the impact of T21 laws could be further maximised, including: Increasing random compliance check inspections Identifying high-priority locations to address access to tobacco by young people, especially in areas where tobacco retail density is high Levying maximum penalties for each infraction to help deter illegal sales and to defray the cost of enforcement activities Publicising fines and license suspensions Revoking and then retiring the license to sell tobacco when multiple infractions occur Pursuing maximum criminal penalties for illicit tobacco suppliers Continuing to study such laws in real-world settings to optimise effectiveness

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The study also did not explore microbiological or immunological markers, which could have helped to elucidate the mechanistic pathways linking SLT use with periodontal destruction