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It reverses or halts the effects of the work that has been done to improve health care in these countries, and although smoking is deemed as a "voluntary" health risk, the marketing of tobacco towards very impressionable adolescents in the developing world makes it less of a voluntary action and more of an inevitable shift

Variation in CYP2A6 leads to dramatically different rates of nicotine clearance among individuals, classified as normal, intermediate, slow, and poor metabolizers [22]

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[83,89] Briefly, the reduced quantities of transported O2 and the decreased O2 supply to and uptake from the active tissues, combined with the binding of myoglobin by CO, significantly decrease maximal oxygen uptake (VO2max) reducing the functional capacity and the performance of the circulatory system ( Figure 2 )