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Interpersonal Relationships: Tobacco addiction strains relationships with family members, friends, and romantic partners, particularly if nonsmokers are concerned about the smokers health or the effects of secondhand smoke

51 After adjustment for multiple potential confounders, such as race, education, current alcohol consumption, exercise, aspirin use, body mass index, and dietary fat consumption, Henley and colleagues 51 found spit tobacco use in CPS-I and CPS-II was associated with an increased hazard ratio for mortality due to cerebrovascular disease (Table 6)

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