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As for the quitters, who had on average smoked about a pack a day for 30 years, "it took roughly 25 years without smoking for differences in cortical thickness to no longer be observed between ex-smokers and those that never smoked," the authors wrote

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The use of all types of tobacco products increased amongst American Indian or Alaska Native students

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In addition, inspections of manufacturing sites or clinical investigations may be necessary

Acknowledgments We thank all participants in the study