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Reinforced by other evidence, they helped lead more than 30 years ago7,9,25 to the conclusion that the associations observed between smoking habit and mortality are chiefly causal in character (see also the more recent reviews by the US Surgeon General11 and the International Agency for Research on Cancer.12) In most of the causal associations, smoking seems to act synergistically with other aetiological agents such as consumption of alcohol12,26

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Within each domain, 2526 primary sampling units (PSU) were selected as villages or comparable urban units for a total of 437 PSUs

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