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Jin A, Koh WP, Chow KY, et al

A persistent myth suggests that pipe tobacco is somehow cleaner, purer, or less chemically adulterated than cigarette tobacco

[17] "That was a great try

But in impoverished places like this Clay County, in eastern Kentucky nearly 4 in 10 do

Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible