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The researchers also found that young men and women who smoked were more than twice as likely to have a fatal cardiovascular event as their first sign of cardiovascular disease compared to nonsmokers

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Still, a strength of this study is the inclusion of any measure of secondhand smoke exposure, which was not available for inclusion in the NHIS study and has not been examined as a potential confounder of the relationship between childhood smoking and COPD risk in prior work

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