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77 In 2021, the WHO, AHA, ACC, and ESC issued a joint tobacco endgame statement, calling for accelerated global action to eliminate tobacco use as a driver of CVD and premature mortality 25 In their recent 2025 report, the European Environment Agency (EEA) firmly rejects the tobacco industrys harm reduction narrative

Cost is also an important factor and larger packs may be linked to increased smoking because they have a lower cost per cigarette

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It can cause cancer, particularly leukaemia, in humans