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Tobacco users also exhibited shifts in species abundance over time and the presence of opportunistic pathogens such as Neisseria subflava and Porphyromonas endodontalis , highlighting tobaccos impact on oral microbial composition [80]

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Skeletal muscle wasting can initiate a downward disease spiral, where muscle weakness and inefficient metabolism at low exercise intensity further decrease exercise capacity [64]

This abnormal lung function could persist throughout a child's life