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The activation of nicotinic receptors at the neuromuscular junction by SHS can also cause degeneration, consistent with a key role for smoke exposure causing denervation in patients with chronic pulmonary disease ( FIGURE 2 Inhaled nicotine can also have long-term effects on brain development, because nicotinic acetylcholine receptors (nAChRs) play a very important role in modulating the release of neurotransmitters during key stages of neurodevelopment ( e.g