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However, their integration into harm reduction strategies must be accompanied by continuous surveillance, transparent reporting, and rigorous long-term research to evaluate safety, usage patterns, and population-level health outcomes

This reduced fatigue resistance in the previous smokers was thought to be at least partly attributable to elevated COHb levels, seen also in the current and other studies 23,47 that not only reduces the oxygen carrying capacity, but also the release of oxygen due to the left-shift of the Hb-dissociation curve 17,24

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