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In Texas, the middle 20 percent of income earners ($35,800-$56,000) pay 9.7% in state and local taxes in contrast to middle income Californians ($39,100-$62,300), who only pay 8.9%

But your patient may not have considered the less obvious link between smoking and slow healing of chronic wounds unless you bring it up

The ASSIST, developed by the World Health Organization (WHO), evaluates a broad spectrum of substancesincluding alcohol, tobacco, and various drugsthrough an 8-item questionnaire, making it versatile for identifying multiple substance use disorders

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