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Use is highly prevalent among individuals in physically demanding or sustained-alertness occupations, such as taxi or truck driving and construction, where it is often used as an anti-fatigue agent

Nicotine narrows blood vessels, reducing blood flow to the penis

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But the behaviors are more commonly seen in teens who use tobacco

While educational attainment generally reduces smoking prevalence, high-income Chinese-Americans continue to experience elevated smoking rates, suggesting that the protective effects of socioeconomic status may be smaller for historically marginalized groups (38, 39)