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Clinicians are encouraged to assess tobacco use at postpartum visits as well as infant and child wellness appointments during the first year after birth

"Without structured pathways for advancement, there is a growing risk of creating a 'missing middle' - a large segment of the workforce that powers consumption but remains excluded from stability, protections and long-term economic mobility," the report said, calling for better social protections, minimum wages and creating pathways to higher-skilled roles that pay better