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Prim Care Clin Office Pract 42 (2015): 569-589

They are smoked to mark significant occasions, such as the birth of a child or an anniversary, and are frequently shown in caricatures of the wealthy and capitalism

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Surrounding this cartouche is a plethora of

10 Cigarettes per day = 0.5 packs Multiply 0.5 (packs) by 6 (amount of years smoking) Answer is a pack year number of 3

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