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It has been linked to several cardiovascular ailments such as heart attacks, brain strokes, blood clots and stiffening of the arteries not only in the heart but also in the arms and legs." "Smoking causes stiffness and plaque buildup within the blood vessels that carry oxygen to the heart muscle

& Bunney, B

We provide evidence on relative mortality hazards regarding exclusive SLT use and cigarette smoking relative to never-tobacco use

The key elements include: Screening/risk assessment to quickly identify at-risk individuals Brief intervention focused on increasing awareness and motivation toward behavioral change Referral to treatment to facilitate access to care For additional guidance on implementation and reimbursement based on this framework, see Substance Abuse and Mental Health Services Administration (SAMHSA): Screening, Brief Intervention, and Referral to Treatment (SBIRT) and Box 2: Implementing Substance Use Screening in Primary Care Settings