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"Hard-core Smokers, the Hardening Hypothesis and Harm Reduction: Implic" by Tanya Pauline Buchanan

Background: The prevalence of cigarette smoking has decreased considerably in many developed countries over the past few decades. However, in Australia, the rate of the decrease has been slowing, and between 2013-2016, appeared to stall. This is important because cigarette smoking remains a major public health issue, and is – for example – the leading cause of cancer-related mortality in Australia. The slowing decline in smoking prevalence has prompted calls to address the interrelated issues of hardening and hard-core smoking. The hardening hypothesis proposes that, as smoking rates decline, the remaining smokers will become hard-core (i.e., more resistant to quitting). This group of hard-core smokers may require more tailored approaches to cessation and/or product-based tobacco harm reduction (THR). Although hardening and hard-core smoking are often discussed and investigated, the literature is plagued by inconsistencies in how these terms are defined and operationalised. As a re ....

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