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Individuals with rheumatoid arthritis who smoke have an increased risk of greater disease severity and may be less likely to experience remission

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Biological causes: Tobacco use induces neurochemical changes through stimulation of nicotinic acetylcholine receptors, which prompt the release of neurotransmitters that produce pleasure and satisfaction, according to the third chapter of the book Neurobiology of Addictions published in 2016 by the Oxford University Press