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Nicotine has toxic effects on the endothelium, and thus nicotine may play a key role in impaired nitric oxide synthase-dependent vasoreactivity observed in tobacco users

The second mechanism is alcohol leading to oxidative stress, which occurs when there is an imbalance of free radicals and antioxidants in the body, according to the Centers for Disease Control and Prevention (CDC)

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Exploring the association between lifetime prevalence of mental illness and transition from substance use to substance use disorders: results from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC)