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The blend is centered on Virginia tobacco as the primary component , historically including domestically cultivated leaf processed through flue-curing methods

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It is possible that the hyperinflation seen in cannabis users in addition to the Valsalva maneuver often used with inhalation may be involved in the cases of spontaneous pneumothorax and/or pneumomediastinum and of the peripheral apical lung bullae [50] that have been reported in isolated cases of marijuana smokers

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Additionally, it may increase exposure to harmful substances, and carcinogens, and raise the risk of respiratory diseases