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Though there are certainly higher-end cigarettes that are exceptions, many mass-produced cigarettes include considerable amounts of biomass from tobacco stems that have been processed into usable tobacco sheets

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In contrast, discounted pack-years, the most nuanced of the indicators, takes into account the length and intensity of smoking, as well as the time since cessation, which are important factors when considering the potential health impact of smoking on individuals and at the population level 7,9