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A previous study in the United States examined the disparities between rural and urban residents and reported no significant differences in several regions, which is consistent with the current findings 36

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2001 US Department of Agriculture, Commodity Economics Division Research Service: Washington, D.C US Department of Health and Human Services

These differences between the two variables translate into a linear increase in the COPD risk with pack-years from practically the beginning, so that the lack of effect observed in duration is compensated by the effect observed in intensity