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Notably, animal models have shown that the adolescent brain is more susceptible to the addictive and neurotoxic properties of nicotine in comparison with the adult brain as it may influence the expression of genes involved in the neuroplasticity of frontal brain regions and may cause changes in macromolecular constituents indicative of cell loss (reduced DNA) and altered cell size (protein/DNA ratio) in the cerebral cortex, among other neurostructural and neurochemical alterations (710)

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The authors simply state patients were asked and data were collected in the context of care

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