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In addition, exposure to tobacco smoke extract (TSE) exposure can cause human macrophages to release EVs (including exosomes and ectosomes), which contribute to the release of matrix metalloproteinase 14 (MMP14) and may contribute to emphysema [102, 103]

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Dr Sarah Jackson, study author and principal research fellow in the UCL Tobacco and Alcohol Research Group, added: 'This 15-year study captures shifts in smoking behaviour, showing that while the average number of cigarettes smoked per day has fallen, this trend has stalled since 2019

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