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People who had ever chewed khat were 4.5 times more associated with ACS than people who had never chewed khat, and current khat chewers were 5.4 times more associated with ACS

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And this makes it harder to quit. Schlam believes that a next step may be to teach people who smoke how to better cope with distress through various forms of therapy, or by creating and using just-in-time adaptive interventions, like cell phone apps which can distract the user from smoking as needed with a mindfulness exercise or a video of something important to them