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Accordingly, a lot of effort has been directed at discouraging young people from picking up that first cigarette

Mayer reported that in the mid- to late-1800s the disease was known in the Netherlands and that he had observed it once in Germany, near Karlsruhe (17)

The report found that by the early 1980s, although most Americans were generally aware that smoking was hazardous, many in the public, especially smokers, did not have sufficient information about the health risks of smoking to understand just how dangerous smoking was for them (Myers 1981)