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However, a bidirectional Mendelian randomization study tested post-hoc the impact of both smoking initiation and total lifetime smoking on risk of BD in a large sample of subjects participating in genome-wide association studies (GWAS, including 20,129 cases and 21,524 controls), using summary level data (39)

Nicotine influences the brain cells Nicotine influences the brain cells either by binding to active receptors or by releasing acetylcholine or mono aminergic neurotransmitters such as dopamine, noradrenaline and serotonin