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State-level estimates of cigarette smoking prevalence, while useful for beginning to explore differentials within the US and indispensable for informing state-level tobacco control policies, do not provide the same level of resolution as our county estimates and hence mask important local differences in both the current level of smoking prevalence and in trends

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METHODS This study employed a reality-oriented qualitative inquiry approach, which believes that informants perspectives are shaped by and grounded in their real-world experiences 23