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60 Two measures of inflammation, high-sensitivity C-reactive protein (hs-CRP) and fibrinogen , rose sharply after a single cigarette, with the effects lasting up to 35 minutes

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Articles were excluded if they: (1) reported litter and cigarette butt densities using the items per meter unit, (2) lacked numerical data on cigarette butt density or the specific percentage among anthropogenic litter, (3) focused solely on public perception or smoking behavior, and (4) were conducted exclusively indoors or in controlled laboratory settings

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