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Back in episode 80 what did the tissues given to America mean?

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Those were "pocket tissues" with ads on them. It's a form of promotion. Such is an every-day experience when you live in Japan. Basically, the girl wasn't giving away the tissues just from the kindness of her heart, like America assumed. Also, sometimes there are advertisements for... "special services" *cough* prostitution *cough* on the tissues, which could also be part of the punch line.

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