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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"This study was determined as not human subjects research as data were not directly obtained by these researchers through intervention\/interaction and identifiable private information was not utilized. A secondary data analysis was completed of the National YRBS, publicly available and de-identified data. Data is available for download at:","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Current Study"}},{"value":"Informed consent was obtained from all respondents of the National YRBS. Location parental permission procedures were followed.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}}]}}