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Possible contributing factors include: Reduced blood flow to the inner ear Increased oxidative stress Damage to delicate hearing structures Smoking combined with loud noise exposure may further increase the likelihood of hearing damage over time

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Researchers have not found a way to quantify precisely the contribution of each of the policy factors described above, and those highlighted in Figure 2.7.3 , however it is probable that these would have all contributed in some wayeither directly or indirectly, in the longer if not the short termby having: reduced the glamour and appeal of tobacco products increased knowledge about health effects reduced cues or opportunities to smoke reduced the social acceptability of smoking reduced withdrawal symptoms during quitting, or increased knowledge about how to manage the quitting process

Integrating compliance considerations into early-stage product planning can minimize future adjustments and accelerate market readiness once new requirements are enforced