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This is probably the case with alcohol, the consumption of which (at least in moderation) is associated with a reduced risk of ischaemic heart disease.36,37 If, as now seems likely, the consumption of a few units of alcohol a day can reduce the age specific mortality from ischaemic heart disease, then the confounding of cigarette consumption with the consumption of alcohol would mean that the total effect of cigarette smoking on ischaemic heart disease mortality is slightly more than that hitherto reported

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