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In addition, a mixture of carbon monoxide and nicotine increases the blood pressure and heart rate, and can easily lead to heart attacks and stroke (Kozlowski et al

Finally, peroxynitrite inactivates prostacyclin synthase by activating NF-B and increasing nitric oxide synthase expression in endothelial cells in vitro , which also leads to endothelial dysfunction ( in vitro studies of human gingival epithelial cells (Semlali et al., 2012) and macrophages (Yang et al., 2006), smoking leads to dysregulation of TLRs and NF-B, which contribute to atherogenesis by promoting OxS, inflammation, and endothelial dysfunction (Lazaridis et al., 2021)