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Anecdotal evidence had always pointed to negative health effects from smoking, and by the 1930s physicians were noticing an increase in lung cancer cases

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Review of the Negative Health Consequences of Cigarette Smoking In determining whether FDA should, as authorized by section 4(d) of the FCLAA, adjust the format, type size, color graphics, and text of any of the label requirements to promote greater public understanding of the risks associated with the use of tobacco products, FDA reviewed the scientific literature as well as available nationally representative data on current consumer knowledge and misperceptions about the health risks of smoking