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This can be explained by ongoing smoking declines in the state, fortified by the statewide smoke-free law implemented in December 2006 and by the large federal tobacco tax increases in early 2009, which significantly reduced smoking and other tobacco use nationwide

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The GUI survey questions about substance use were asked using a sensitive questionnaire which the teenagers had to complete by themselves, and they were assured of confidentiality and anonymity

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To motivate smokers to quit, explanation of the harmful effects of smoking can be effective, because health issues are of primary concern to many people