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Setting and participants This study surveyed tobacco farmers in the northern region of Thailand who met the following inclusion criteria: 1) they were either the head of the household or the person primarily responsible for growing tobacco within the household, 2) they held a valid license for growing Virginia or Burley tobacco varieties issued by the Tobacco Authority of Thailand (including both contract and independent farmers), 3) they had actively grown tobacco during the previous agricultural season, and 4) they provided informed consent to participate in the research study