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134 FDA also issued a proposed rule in September 2019 for PMTAs that, among other things, would require manufacturers to "keep records regarding the legal marketing of certain tobacco products without a PMTA." 135 Prior to 2009, restrictions on the distribution of tobacco products were largely enforced at the state level, and promotion of cigarettes and smokeless tobacco was largely overseen by the Federal Trade Commission (FTC)

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Using the Joinpoint software, the temporal trend in ASRs for smoking-related bladder cancer from 1990 to 2021 was measured using the APC (annual percent change) and the AAPC, as well as their 95% confidence intervals (95% CI) 17