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The causal chain of events linking smoking to genetic damage To answer the first question, let us consider the causal chain of events linking smoking to genetic damage: Emission of carcinogenic toxicants leads to exposure to carcinogenic toxicants, which in turn leads to metabolic responses to toxicant exposure, genotoxicity, and DNA damage
For example, ENDS that dont contain nicotine are not subject to the California excise tax on tobacco products, while ENDS that contain nicotine are subject to the tax
Alcohol versus other risk factors Among New Zealanders aged 15-49 years, alcohol causes more death and disability than smoking, poor nutrition, or other unhealthy behaviours
Additionally, urban areas in two major Brazilian cities reported hotspots in 2021, with 0.90 in Santos and 1.16 cigarette butts per square meter in Niteri [69]
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