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After the Civil War, when smoking became popularized, in part due to health reasons when spitting, which one had to do with cigars and spitting tobacco was frowned upon and in many instances outlawed because of the spread of tuberculosis cigarettes, became increasingly popular, and to increase their favor among men pinups, were included on little cardboard cards in each cigarette pack

Smokers would have been less likely to have lived long enough to enter our study than never-smokers." Smoking rates have plummeted in the U.S