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Additionally, smoking imposes substantial economic costs on healthcare systems, costing the US around $170 billion in direct cost for medical care and over $156 billion in indirect costs due to productivity loss, including $5.6 billion in lost productivity among nonsmokers who suffer from smoking-attributable conditions because of involuntary exposure to secondhand smoking (Department of Health and Human Services, 2014

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Hyperpigmentation of the lips and gums is usually seen in chronic smokers

Less commonly, clots may form in veins elsewhere in the body