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Our secondary analysis reinforces this interpretation

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While its not the primary cause of diseases associated with smoking (such as lung cancer, emphysema, or cardiovascular disease), nicotine does have various health effects on its own: Nicotine is highly addictive

Counties with statistically significant declines represent a disproportionate share of the population, however, such that 74.4% of the adult male population and 61.1% of the adult female population in 2012 lived in counties where the decline in total cigarette smoking prevalence was statistically significant