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However, when all these factors were accounted for, heavy smokers were still dis-proportionally overweight

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Cotinine is a metabolite of nicotine, and its presence in urine serves as an indicator of recent nicotine exposure, including the use of tobacco products and electronic cigarettes (vaping)

Heavy smokers may need to take frequent puffs or use efficient devices (e.g., pod systems or sub-ohm mods) to ensure they get enough nicotine