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The morbidity and mortality associated with cigarette smoking have been documented repeatedly, but the toxicity of nicotine itself is more complex and less well understood. The toxicity of nicotine is relevant to the differences in risk among various tobacco products, and it has emerged as a major issue in the use of nicotine-substitution preparations to aid in the cessation of smoking. These products are unequivocally effective as aids to cessation, but there is uncertainty about their acute and long-term toxicity. Many smokers and even a few physicians have taken the position that the use of nicotine-substitution preparations merely trades one
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