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These data advance the concept that significant increase in the concentrations of nicotine and cotinine, significantly higher levels of triglycerides, VLDL-C, total cholesterol (No significant change in khaini users), greater levels of protein carbonyls, peroxynitrites, malondialdehyde, and nitric oxide (No significant change in experimental groups), diminished levels of hemoglobin, HDL-C (No significant change in gutkha group), observed in the plasma of gutkha and khaini users compared to normal healthy controls

Scientific data and sources Research summary Level of evidence Strong Number of included studies: 96 25 studies 21 studies 19 studies 17 studies 5 studies 4 studies 3 studies 2 studies Final comment: Smoking tobacco is one of the best-documented risk factors for many chronic diseases, including cancers, cardiovascular diseases, and lung diseases

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Blood-brain barrier breakdown is an early biomarker of human cognitive dysfunction