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While the precise mechanisms by which smoking increases cardiovascular disease are still being discovered, it has been shown to exert direct myocardial effects, such as increasing myocardial oxygen demand, lowering the threshold for angina, and Impairing exercise performance (Figure 2)

12 Other modalities are needed to help addicted teens quit

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In national data from undercover compliance checks of tobacco sale laws, approximately 80% of stores requested identification from minors, but sales after identification requests constituted nearly one-quarter of all violations