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Taken together, tobacco product users are clearly exposed to a multitude of toxic chemicals at once, and so far, data have shown that the “collective” effect of tobacco on hemostasis is shifted towards thrombosis, rather than the other way around

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For example, opioids decrease pulmonary perfusion via hypoxia-induced pulmonary vasoconstriction 143 , and by direct pulmonary vasoconstriction 144,145 by mechanisms including centrally-mediated activation of sympathetic nerve activity to the lungs 146 , and induction of histamine release in the lungs 144,147