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If we then have physiological evidence to show how smoking might cause the disease, then this adds up to strong evidence that smoking does indeed cause the disease

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The principal constituent of smoking that affects body weight is nicotine, which reduces body weight by: suppressing appetite and food intake increasing energy expenditure raising the resting metabolic rate increasing lipolysis and fat oxidation, which are processes in which the body breaks down fats into smaller molecules to use as a source of energy The authors of the 2022 review noted that when people gain weight after quitting smoking, it is largely due to nicotine no longer affecting the central nervous system