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Premium cigar makers typically use two key defenses: Tobacco fumigation during processing Freezing cigars before packaging kills off any larvae Cigars from Honduras, Nicaragua, and the Dominican Republic tend to follow strict quality control practices

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Ex-smoker status was not independently associated with gout in women in the NZ Mori GGA (aOR 2.14, 95% CI 0.85-5.38, P = 0.11) or NPH cohort (aOR 5.77, 95% CI 0.67-49.88, P = 0.11)