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On the other hand, substance use, including nicotine exposure, may cause damage to the brain and accelerate brain aging potentially through its neurotoxic properties, indirectly exacerbated by excessive smoking 8,10

The significant associations of phenanthrene tetraol and total NNAL with lung cancer after correction for total cotinine most likely are related to the potent lung carcinogenicity of PAH and NNK, which cannot be completely accounted for simply by measurement of total cotinine in urine

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