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We then estimated the risk ratios (RRs) and 95% confidence intervals (CIs) of birth congenital anomalies (i.e., which showed positive associations in the initial analysis) according to smoking intensity before and during each trimester of pregnancy

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Between 1983 and 2004 in particular, cigarette consumption per capita fell by half, a drop driven not just by quitters but also by a decline in the number of cigarettes smoked per day among those who smoke. And that trend continued in the following decade