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"Trends in maternal use of snus and smoking tobacco in pregnancy

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For cohort studies, we utilized the Newcastle-Ottawa Quality Assessment Scale for quantitative analysis, the Newcastle-Ottawa Scale was developed to assess the quality of nonrandomized studies with its design, content and ease of use directed to the task of incorporating the quality assessments in the interpretation of meta-analytic results (20)

Smoking negatively impacts the function of blood vessels (and thus blood flow) in the body, including the ear