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N Engl J Med 340 : 685691

The cigarette is ignited at one end causing the cigarette to smoulder and allowing smoke to be inhaled from the other end, which is held in or to the mouth

Thats between you and your own convictions

First, this sample of dual users was demographically diverse but small, restricted to adults aged 21years, and recruited online mostly through Facebook and Instagram, limiting generalizability to those aged 21 years and with internet access and social network accounts

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It can be a sudden fall, moisture, or rough handling during shipping and storage