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According to the World Health Organization (WHO) about 1.1 billion people smoked tobacco in 2015

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In the wake of the Surgeon General's 1964 report, Koop said that he "frequently spoke of the sleazy behavior of the tobacco industry in its attempts to discredit legitimate science as part of its overall effort to create controversy and doubt [surrounding the relationship between smoking and lung cancer]." The word "doubt" carried singular meaning in tobacco-policy circles, having been used in an infamous 1969 memo circulated within Brown and Williamson Tobacco Company, the maker of Pall Mall