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That 1964 surgeon generals report on smoking and health spurred profound and lasting changes in tobacco use and policies in the United States, but its call to action has gone unfulfilled internationally

the meta-analysis suggested that conservatively, using smoking tobacco products increased the risk of stroke by 16%

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Furthermore, given the limited availability of studies that assess exposure to tobacco smoke on the basis of environmental and biological samples, and the lack of a standard measure of SHS exposure, the units and dose categories reported across studies vary widely