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It also blocks the receptor from nicotine should the patient smoke while on it

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Writing in Nature , Duncan et al

What Does Manitou Virginia Green Tobacco Manitou Organic / Virginia Green has nothing added during the production process, this includes even whilst it is being grown, no pesticides or other chemical treatments are used in the cultivation of the tobacco plant meaning you know that you're smoking just pure tobacco

The large surface area of activated carbon allows it to capture and neutralize volatile organic compounds (VOCs) and other odor-causing chemicals found in cigarette smoke