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Impaired endothelial function, arterial stiffness, increased inflammation, lipid alteration, and prothrombotic factors are associated with smoking and appear to initiate as well as accelerate the atherothrombotic process, eventually leading to cardiovascular events 3

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This effect in smokers could be linked to maladaptive threat responses that are observed in individuals that suffer from pathological anxiety

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National Cancer Institute Monograph No 67, NIH Publication No 852713 Hammond EC: Smoking in relation to the death rates of one million men and women