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This shift has significantly impacted major tobacco companies

However, many people are not sure whether smoking a little is bad for them or whether the consequences of smoking tobacco are only severe if they smoke a lot

The survey item did not explicitly refer to spliff use and this is noted in the Limitations section

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The American Lung Association also advocates additional research but argues smoke is harmful to lung health and that marijuana has been shown to contain many of the same toxins, irritants and carcinogens as tobacco smoke. Marijuana may also be more harmful to the lungs because of how people smoke it, Rizzo said

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