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Additionally, bypassing the extended-release feature can cause a dangerous overdose

A report of the Surgeon General, 1986

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Some groups, like black Americans, also suffer disproportionately high levels of smoking-related illness and death, despite smoking at similar or even lower levels than other groups

In contrast to the modern association of tobacco with death and illness, tobacco is a symbol for peace and healing among many American Native communities, where its traditional association with peaceful negotiation, with medicine, and with prayer remains strong