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During the counselling, it might be apparent that patients are unwilling to quit due to a wide range of reasons, from being unaware of cigarette smokings harmful effects to not having the financial resources to facilitate smoking cessation (Figure 5)

The line "Is it worth the aggravation to find yourself a job when there's nothing worth working for?" taps into a sentiment of disenchantment common in the 1990s

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It also uses the case as a significant example of Washingtons success in bringing about fundamental change in Japans political economy during the 1980s