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Approximately 42.4% of U.S. adults have ever smoked cigarettes, with half of those (20.9%) being current smokers (Centers for Disease Control and Prevention 2005). The prevalence is higher among men and the poor and decreases with increasing educational levels. Fewer than 9% of adults report past-month cigar and/or smokeless tobacco use. Although tobacco use has been declining in the United States, it is increasing worldwide.

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