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The research also proves nicotine to be a potential agent for initiating stress reactions in the gums and serves as an environment-modulating or altering factor in the oral cavity that helps the bacteria to thrive in high metabolism

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Develop a strategy that will be combating tobacco manufacturers

Acknowledgements We would like to thank Frank Chaloupka and Raymond Boyle for comments on a previous draft of this paper

Discov Public Health 23 , 505 (2026)