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Our finding that males are seven times more likely to use any type of tobacco is consistent with other studies conducted in Ethiopia such as Guliani and colleagues observation [52] and similarly, findings from Defar and his colleagues indicated that males are ten times more likely to smoke tobacco than female [17]

The ESSI can identify young people who are at risk of starting to smoke cigarettes and related products

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Lighting a cigarette and burning otherwise harmless additives such as glycerol and sorbitol triggers the release of acetaldehyde, which not only is toxic but also blocks enzymes required for the body to produce more dopamine