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Dr Suzanne warns that there is no safe threshold. She also explained: Even though the absolute risk from a single event is very small, one exposure triggers inflammatory changes within the vascular lining and oxidative stress at a cellular level. Ultimately, she believes its not just about one cigarette in isolation, saying Risk is not binary, and what concerns us clinically is not so much the one off cigarette, but the behavioural trajectoryRepeated just one scenarios can gradually shift into a pattern of intermittent or regular smoking, and it is that sustained exposure over years that meaningfully alters long term health outcomes.