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The people in Brazil, Central America, and the Caribbean islands smoked small, rolled tobacco leaves wrapped in large leaves

When using this product, do not smoke even when not wearing the patch

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Methods: Using data from the Global Burden of Disease study (GBD) 2021, we estimated the burden attributable to substance use in terms of the number and age-standardized rates (ASRs) of deaths and disability-adjusted life years (DALYs) from 1990 to 2021