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In general, it is not clear if the upregulation or downregulation of antioxidant enzymes is positive or negative signal, but it is clear that smoking impairs the response and the ability of the antioxidant defense system to address acute and chronic oxidative stress

Smoking is associated with elevated low-density lipoprotein cholesterol, decreased high-density lipoprotein cholesterol, increased blood catecholamine levels, increased fibrinogen levels, and impaired vascular endothelial function [36,37,38,39,40,41,42,43,44,45,46,47,48]

Learn more about the groups lessons learned in the Health Affairs blog written by Hall and his colleague Jessica Hembree, Raising the Age of Purchase for Tobacco Products: Lessons Learned From Tobacco21 Whats next