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The effect of smoking on the heart and blood vessels occurs even at very low levels of smoking indeed, smoking only one to four cigarettes per day has been associated with increased risk of cardiovascular disease, so even if a smoker is able to cut back to only a few traditional cigarettes a day, there may not be much benefit to his or her health

Methylation is the mechanism by which gene expression is modulated and genes are silenced

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This implies a community approach, with preventive policies at the state and municipal levels involving all social and educational agents, with special emphasis on the family, especially those who are also more vulnerable to tobacco consumption