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Even as regulations tighten and public health awareness increases, cigarette consumption remains concentrated in low- and middle-income countries, where 80% of the worlds smokers reside

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The criteria dating back to the 1964 Surgeon Generals report remain useful as guidelines for evaluating evidence (USDHEW 1964), but they were not intended to be applied strictly or as a checklist that needed to be met before the designation of causal could be applied to an association

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