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Systemic-level barriers Eleven studies explored systemic barriers and the intersecting tensions related to socioeconomic deprivation, rurality, inequitable funding models, referral patterns, and political and media influence [4, 7, 10,11,12, 16, 22, 28, 29, 33, 34]

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What is fortunate is that experienced pipe smokers are pretty much universally pleased to help, advise and mentor those who wish to take up the pipe and join our venerable ranks