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Mainstream smoke is the fraction that the smoker inhales directly, and is composed of a particulate phase and a gas phase ( It has been shown that chronic inhalation of cigarette smoke alters cell proliferation, endothelial function ( N -nitrosamines ( Effects of Cigarette Smoke on the Gastrointestinal Tract In addition to the respiratory and cardiovascular effects produced by cigarette smoke, several studies suggest that smoking is also harmful to the gastrointestinal tract, as summarized below (Table 1)