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The procedure, which originated in the late 1980s in community hospitals rather than in academic medical centers, became so popular that by 1991 it accounted for 400,000 of 600,000 gallbladder removals

Nicotine is addictive because it stimulates the brains reward system by activating nicotinic acetylcholine receptors and increasing dopamine release in the nucleus accumbens, creating pleasurable sensations that reinforce continued use