does chewing tobacco affect heart Smokeless use and circulatory disease risk: a systematic review and meta-analysis High school athletes using smokeless

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Additional methylation alterations in IL6 receptor and genes involved in Wnt/-catenin signaling suggest disrupted immune regulation and epithelial development, contributing to persistent lung function decline even after smoking cessation (20)

Discussion Using large summary-level GWAS data and complementary two-sample MR methods, we show that the genetic liability for tobacco smoking has potential causal relationships with several respiratory infection and disease outcomes, including COVID-19

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