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The Hopkins study, though, introduced nicotine to its participants in extremely low doses, so they weren't repelled at first and could, over the course of time, "become familiar with the subtle mood-altering effects," Griffiths says

Even at these levels, smoking is not a major risk factor for this rare disease

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When feasible, contemporaneous biochemical verification (saliva, urine, or serum) provides objective evidence of exposure and can quantify the direction and magnitude of reporting bias in a sample