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The primary pathway for the breakdown of nicotine is called the C-oxidation pathway, whereby nicotine is broken down into the chemical cotinine by the enzyme CYP2A6

Mixing stimulants and depressants can create a dangerous cycle of drug use, leading to significant health risks and potentially fatal outcomes

Addressing smoking is crucial for improving respiratory health and reducing the burden of COPD

Unit of analysis Our unit of analysis was counties or county equivalents (e.g., parishes, census enumeration areas, boroughs, and independent cities)