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Journal of Consulting and Clinical Psychology

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Studies have shown that a characteristic shift in autonomic balance, often marked by heightened sympathetic tone and blunted parasympathetic control [42, 43] Interestingly other studies have reported that physiologically, this imbalance manifests as increases in heart rate, blood pressure, and myocardial contractility, alongside reduced heart rate variability (an well-known marker of impaired vagal regulation vis acute nicotine exposure cigarettes, ecigs, oral nicotine)