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They are a longer duration of heavy smoking in Americans, a more toxic formulation of American-manufactured cigarettes, a higher efficiency of filters in Japanese cigarettes, lower alcohol consumption by Japanese males, differences in genetic susceptibility to tobacco carcinogens, and a higher background risk of lung cancer among non-smokers [9]

Smoking is the leading cause of tobaccorelated death worldwide, contributing to millions of deaths annually through lung cancer and cardiovascular disease

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