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Research has shown that smoking increases the heart rate, tightens major arteries, and can cause an irregular heart rhythm, all of which can take a toll on your heart, making it work harder

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Ethics declarations Ethics Approval The survey protocols and all materials, including the survey questionnaires, were approved by the Research Ethics Board at the University of Waterloo, Canada (REB#20803/30570 and REB#21609/30878), Kings College London, UK (RESCM-17/182240), Cancer Council Victoria, Australia (HREC1603), University of Queensland, Australia (20160000330/HREC1603), and Medical University of South Carolina, USA (waived due to minimal risk)

It's about those small, intimate details like the act of smoking a cigarette out a window that become loaded with meaning in a specific relationship

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