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The Spanish did have some natural immunity, since the diseases were present in Europe at that time

Adapting school-based substance use prevention curriculum through cultural grounding: A review and exemplar of adaptation processes for rural schools

doi:10.1016/j.fct.2018.11.020 43

The American Dental Association has long been a proponent of educating the public about its hazards and has urged for continued research into the adverse health effects of tobacco use