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Thus, smoking has adverse negative effects on the cardiovascular system and functions by its direct influence on the cardiac organs in terms of altering its function of blood and oxygen transportation due to narrowing of blood vessels and direct damage to the heart organs

4.5 Limitations and strengths This study has several strengths, including a relatively large sample size, the inclusion of students from multiple academic programs, and the use of validated instruments to assess knowledge, attitudes, and nicotine dependence

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