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The first study examined dogs affected by myxomatous mitral valve disease and found that individuals living in households with smokers exhibited statistically significantly lower plasma concentrations of tetrahydrobiopterin (p=0.01) [a cofactor for endothelial-derived vasodilator nitric oxide, whose depletion is associated with oxidative stress], suggesting that passive smoke exposure may contribute to oxidative imbalance 37

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He had been a smoker for 33 years, and in 2018, he smoked around one pack of cigarettes a day

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