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As such, during the late Qing reforms, mahjong became considered a social issue. Mahjong started to become outlawed indirectly as gambling and smoking opium became criminalized. The ban was not very successful, however, at least until the Chinese cultural revolution.

Hong Kong Mahjong is the most popular variation of the Mahjong game. It originated in the 19th century and is played with four players who aim to create specific combinations of tiles to achieve the highest score.