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This has been the industry standard since the mid-20th century and is enforced by federal and state tax regulations

Key Features of the Study First study to evaluate the genetic effects of smoking on normal, healthy, non-cancerous lung cells 16 participants were included in the study Participants were categorized into the following: Current smokers Ex-smokers Never smokers Children Lung biopsies were taken from all the participants and subjected to genetic analysis DNA from 632 individual cells obtained from the biopsy tissue samples were sequenced Alterations in the genetic patterns in these non-cancerous lung cells were analyzed Key Findings of the Study 9 out of 10 non-cancerous lung cells of current smokers harbored up to 10,000 extra mutations compared to non-smokers The mutations were caused by carcinogenic chemicals present in tobacco smoke Over one-fourth of the damaged lung cells had at least one cancer-driver mutation Majority of lung cells in ex-smokers remained undamaged from their past smoking These lung cells of ex-smokers were genetically identical to those present in people who had never smoked Ex-smokers had 4-times more of these healthy lung cells, compared to those of current smokers These healthy lung cells of ex-smokers accounted for 40 percent of total lung cells Our study is the first time that scientists have looked in detail at the genetic effects of smoking on individual healthy lung cells

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Study outcome The primary outcome was hemoglobin level (g/dL), measured using the HemoCue Hb 301 system, a validated, point-of-care device with 90% sensitivity and 80% specificity [20]