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Drinking alcohol increases the risk of mouth, upper throat (pharyngeal), oesophageal, voice box (laryngeal), breast, bowel and liver cancer

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Even with smuggling on the decline, the estimated volumes were still considerable: Between 135 million and 278 million packs of cigarettes were estimated to have illegally entered California in fiscal year 1998, representing between $50 million and $103 million in potential excise tax revenue.[199] The moderate decline in illicit smuggling that lasted 10 years between 1988 and 1998 ended when California voters raised the cigarette tax by 50 cents per pack, from 37 cents to 87 cents, by approving Proposition 10 in November 1998

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Yet it cannot be considered a true laggard like most European countries it is on a downward trend with fewer deaths in 2019 than in 1990 (from 184,466 deaths in 1990 to 143,642 in 2019)