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Deborah Hellyer, a respirologist from Windsor, Ont., argued that "smoking one joint is the equivalent to smoking 10 cigarettes" so physicians have an obligation to take a stand

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Although part of a lower strength may at least in theory be attributable to a lower ability to voluntarily activate the muscle, we found no difference in voluntary activation between smokers and non-smokers, and if anything, even an increased VA has been reported in smokers 19