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Interpretation, Strengths, and Limitations This nationwide study demonstrates that starting smoking at a younger age substantially increases the risk of MI and stroke after statistical adjustment for cumulative smoking exposure, and that early initiation intensifies the cardiovascular harm associated with heavier smoking

Although increased calls for federal, state, and local legislationon taxes, warning labels, teenage access to tobacco, and advertising restrictionshave stimulated greater public dialogue, these are less effective steps toward reducing demand for tobacco products than are major paid campaigns in the mass media to undermine the tobacco industry and its brand name products

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