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The high percentage of adults who smoke daily and engage in risky alcohol use in these two countries should be addressed by healthcare professionals regardless of whether it has an impact on tobacco use, as alcohol consumption alone poses significant risks (CDC, 2022), and there are adverse synergistic effects when alcohol and tobacco are used together (Hart et al., 2010

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These determinants represent key targets for preventative and promotive action to improve and sustain the cardiovascular wellbeing of Indigenous populations