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Age group stratification Three age groups were selected based on GBD conventions and WHO standards: 1549 years (to capture early morbidity and emerging chronic disease risk), 5069 years (to assess middle-aged populations where cumulative exposure typically manifests in elevated disease burden), and 70 years (to capture elderly populations with highest mortality risk from long-term smoking-related conditions such as COPD, lung cancer, and ischemic heart disease)

Moreover, the literature suggests that women living in counties with higher concentrations of black and Hispanic residents have a lower likelihood of smoking during pregnancy

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