tobacco use can lead to weakened blood vessels because it smoking and vascular biology and function: evidence from human studies | Pflügers Archiv - European Journal of Physiology How Smoking Affects the Heart

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One six week study found people ended up smoking fewer of those reduced-nicotine cigarettes and reported wanting them less

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Then theres the role of alcohol again

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They described the impact of ST use on subsequent cigarette smoking initiation as "minimal at best." O'Connor et al