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These associations are primarily driven by mechanisms such as the induction of somatic mutations, oxidative stress, and epigenetic modifications, which disrupt cellular function and promote disease progression

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Tobacco or other sacred herbs used in the ceremonial pipe are considered gifts to the spiritual beings, honoring them and seeking their favor, guidance, and protection

While Alsalhen and Abdalsalam 30 found a similar link which they attributed to the positive association between cigarette smoking and hemoglobin levels, our data indicate that the association between bilirubin concentration and smoking is independent of hemoglobin

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