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Under these circumstances, the complete cessation model is a) not realistic, b) extremely difficult to achieve (the number of smokers globally has remained the same, over a billion, since 2000 despite WHO-led multinational efforts to curb use), and c) often leads to coercive policies that do more harm

Funding: This work was supported by National Cancer Institute Grant CA-87472

Appalachian mountain women, Breton peasants, or lower-class prostitutes smoked pipes

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This has been a problem particularly in Africa, where tobacco is often cured by smoke