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It is important to establish the nicotine dependence level in someone trying to stop smoking so that more accurate treatment and nicotine replacement therapy can be provided and to anticipate the severity of withdrawal symptoms

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Despite the obvious biologic plausibility, the lack of consistent epidemiological evidence might be due to methodological issues including lack of cohort follow-up time into older adulthood (when lung cancer usually becomes clinically manifest), small sample sizes, selection and recall biases, and lack of adjustment for tobacco use in the statistical modeling