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Both in middle and in old age, the increasing difference between the mortality of cigarette smokers and non-smokers arises because the large progressive decrease in the mortality of non-smokers in recent decades has, for the cigarette smokers, been wholly counterbalanced by the increasing death rate ratio of smokers versus non-smokers

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While nicotine causes dependence or addiction, there are other substances in tobacco or cigarettes that can cause toxic effects

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