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More than five million Canadians still use tobacco, and Health Canada estimates its use costs the economy almost $4.4 billion in direct health-care costs each year

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The use of MCDA, in particular in Health Technology Assessments (HTA), has also been widely criticised.[viii] Even the authors of the 2014 article acknowledged that they lacked tangible evidence concerning the dangers of most of the products based on the majority of the criteria used