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This is likely due to the combination of chemicals, including nicotine, that can reduce blood flow and oxygen

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In a study in which vasodilation induced by reactive hyperemia, flow-mediated vasodilation (FMD), in forearm arteries was investigated, it was shown that FMD was decreased in smokers and that FMD decreased with increase in the amount of smoking [20, 23,24,25,26,27, 31,32,33, 42, 48]