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Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the views of the Institutes involved National Institute of Mental Health and Neurosciences, India, Health Sciences Authority, Singapore, and the World Health Organization

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Key Points A large body of literature strongly suggests that cigarette smoke unfavourably influences all major stages of atherosclerosis as well as pathological atherothrombus formation Cigarette smoke contains oxidant compounds that cause oxidative stress in the endothelium, leading to endothelial dysfunction and injury, initiation of the atherosclerotic process, and subsequent formation of atherosclerotic plaques Cigarette smoke promotes the development of vulnerable plaques and plaque rupture by enhancing inflammation and activating matrix metalloproteinases Cigarette smoke causes platelet activation, and promotes platelet aggregation and platelet adhesion to sites of endothelial injury Exposure to cigarette smoke shifts the balance of haemostasis towards thrombus formation by enhancing blood clotting and, at the same time, reducing the fibrinolytic capacity This is a preview of subscription content, access via your institution Access options Subscribe to this journal Receive 12 print issues and online access $189.00 per year only $15.75 per issue Buy this article Purchase on SpringerLink Instant access to the full article PDF

Understanding the cultural context of snus use is essential, but it's equally important to weigh these cultural aspects against potential health risks and make informed choices regarding its consumption

Reynolds Tobacco Company Building (now the Kimpton Cardinal Hotel), it has served as the headquarters of R.J Reynolds Tobacco Company and its parent company Reynolds American since 2009