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On top of that, herbal cigarette smoke had much higher oxidative potential, meaning it triggered more cell-damaging molecules associated with chronic diseases like lung disorders and heart disease.Leaf-wrapped herbal cigarettes, especially those using tendu leaves (like in bidis), were even more problematic, showing nearly a 50% higher oxidative potential than paper-wrapped ones

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The mortality patterns from cigar smoking relate in part to the degree of inhalation by the smoker

Tissue factor: beyond coagulation in the cardiovascular system

Environmental and social factors certainly play some role in the excessively high smoking rates