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If one of these conditions is documented as exacerbated, this does not automatically imply that the other condition is also exacerbated

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Graphic 10: Michigan Cigarette Excise Tax Rates Since 1947 Source: Michigan Department of Treasury, Bureau of Tax and Economic Policy, Tax Analysis Division Michigan's cigarette tax is currently one of the highest in the nation

This is in line with Friedens 77 health impact pyramid, which emphasizes the significance of contextual measures, like policies, for broader population impact compared to the narrower impact of interventions such as clinical or counselling programmes