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Hence, we cannot understate the significance of generational shifts in smoking behavior due to the social norms at a given point in time that signaled acceptability or disapproval of cigarette use, independent of, and beyond, the addictive properties of tobacco

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Joinpoint regression analysis indicated (Supplementary file Figure 3) that although the overall ASDR showed a declining trend (AAPC= -1.19), the rate of decline has gradually slowed (APC 2015-2021 = -0.51)