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It has also been suggested that smoking prolongs the time to recurrence following thiopurine cessation

Another limitation of this study is the use of a self-report measures of smoking status and the absence of bio-verification, considering the potential for fraud in online studies it is difficult to be certain that all participants smoked tobacco weekly [39]

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Oxidative stress can cause cell damage within the ear, damage delicate structures within the ear, and interfere with neurotransmitters in the auditory nerve, which could lead to hearing loss