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Antibiotics, similar to those the patient was taking, can result in new bacteria forming in the mouth, which can accumulate and lead to hairy tongue

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Additionally, the social nature of khat sessions often involves sharing khat leaves among participants, making it challenging to accurately quantify khat consumption 7

Moreover, innovations in more effective nicotine delivery systems that increase nicotine concentration levels while minimizing throat irritation have also contributed to increased rates of nicotine dependence