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People in the Pacific Northwest smoked tobacco long before Europeans showed up Unearthed pipes reveal the earliest record of nicotine use in the region Ancient pipes and pipe fragments found at five archaeological sites along the Snake and Columbia rivers in Washington contain evidence of tobacco use, new research shows

The research articles included were peer-reviewed English-language papers published from 1989 to 2008, and the search was completed in August 2008

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doi:10.1097/PEC.0b013e31816b7a92