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It begins much earlier, at the level of the blood vessels

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The consequences of this repeated and prolonged episodes of reflux can damage the inner lining of the esophagus and increases the risk of esophageal cancer Tobacco and Peptic Ulcer Smoking stimulates acid secretion from stomach and attenuates the defense mechanisms like decrease in blood flow, mucus and bicarbonate production

Smokeless Tobacco Induced ChangesUse of smokeless tobacco produces a specific change in the area of the mouth where it is held