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Clinical trial registration: NCT00332644 (www.ClinicalTrails.gov)

While over 130 countries worldwide have implemented large, rotating picture warnings and 27 have adopted plain packaging Switzerland remains stuck with outdated, fragmented, and weak labelling that protects the tobacco industry far more effectively than it protects public health.

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Becky Freeman, an associate professor of public health at the University of Sydney, acknowledges the only reason people buy black market cigarettes is because "cigarettes are expensive"