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Heart Failure Reviews discusses how smoking accelerates the progression of chronic heart failure and is linked to increased mortality rates among affected individuals (56)

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It affects brain chemistry by influencing dopamine and serotonin, which play a role in reward, dependence, and withdrawal

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10.1016/S0091-7435(03)00110-5 Berlin I: Endocrine and metabolic effects of smoking cessation

But if they fell into dirty water, spilled soda, or something worse, you might want to reconsider before you get acid reflux from that cigarette