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Studies have demonstrated that long-term smoking can destroy the structure of the air duct wall, damage the septum of the alveolar wall, and cause interstitial fibrosis [11,12,13,14]

Any unresolved conflicts were addressed through a Delphi-based consensus process, facilitated by a third investigator 16

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Parents in the intervention group were more likely to have engaged their child in discussions and to have addressed topics identified in the provided materials as being protective of childrens involvement in tobacco and alcohol