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5) back-translation into English was independently conducted by two bilingual experts

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All sorts of correlational effects probably contribute to these results, Clark says

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Participants were asked about their smoking each year, which minimized recall bias and allowed us to model changes in smoking habits over time. Compared to those who never smoked, stable heavy smokers experienced the greatest decline in lung function as measured by FEV 1 , or the amount of air that can be forcibly exhaled in one second (-42.2 mL/year)

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