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While Alsalhen and Abdalsalam 30 found a similar link which they attributed to the positive association between cigarette smoking and hemoglobin levels, our data indicate that the association between bilirubin concentration and smoking is independent of hemoglobin

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Most included studies were cross-sectional, limiting causal inference, and substantial heterogeneity, publication bias, and residual confounding remain important limitations

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Thinking first of his wife, his children, and the generation of young Americans he inspired including me