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Conclusion It is clear that the MSA has not resulted in a clear and straightforward intensi cation of state tobacco control efforts, because of the impact of interest group activity and changing economic situations at the state level

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For example, although progress reports are one way for contractors to demonstrate to the OHP whether they have completed agreed-upon work, the OHP could not demonstrate that its staff had reviewed all progress reports for seven of the 20 agreements that we reviewed for this program

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