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Even with daily brushing and flossing, the constant barrage of carcinogenic compounds makes preventing gum disease nearly impossible for smokers who have a diminished supply of bacteria that could break these chemicals down

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In a large cohort of active young men, dual users demonstrated significantly poorer performance in cardiorespiratory endurance and muscular fitness tests compared to never users, including slower 2-mile run times and fewer push-ups and sit-ups performed, even after adjusting for physical training habits (82)

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