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that directly or indirectly, tobacco causes more than 400,000 deaths in the U.S. annually, a figure that represents nearly 20 percent of all U.S. deaths. These deaths have been attributed to a number of conditions defined as tobacco-related, including heart disease (115,000 deaths), cancer (136,000), chronic pulmonary disease (60,000), and stroke (27,000). According to a study published by the British medical journal Lancet, the rate of tobacco-related mortality throughout the entire developed world also averages about 20 percent of all deaths.

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