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Chapman points out that quitting smoking with no aid remains the most common method of quitting around the world, including England, not only because smokers are not always aware of other methods such as drugs, e-cigs or smoking cessation servieces, but because, from the few qualitative studies conducted on smokers, they perceive quitting with no aid as an adequate way of dealing with the problem, which appeals to their sense of identity, strength, and autonomy

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As with the other prescribing-based analyses, there is no measure of biological exposure to nicotine and almost certain confounding by indication