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Although data from human studies on acute smoking are not consistent, animal studies showed a stable increase in circulating immune cells and inflammatory markers, such as TNF- [77]

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Last year, the Institute of Medicine estimated that increasing the smoking age to 21 would discourage 15 percent of young adults from taking up smoking

Accordingly, we performed several sensitivity analyses, and our findings remain the same when using 2-year cohort intervals, as well as alternate functional forms of age, indicating that these transformations make no substantive difference to the reported results 70,71

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