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Smokers may adjust to the smoke over time, but second-hand recipients may still be affected

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While the observed dose-dependent relationship between serum cotinine levels and alpha diversity supports a directional association, the biological implausibility of reverse causality (i.e., oral microbiota influencing smoking behavior) further strengthens this inference

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Images were captured on a Nikon Microphot-SA microscope with a 50X oil objective using Nikon DXm1200 digital camera