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However, these studies only explored the association of cancer incidence with tobacco consumption and did not examine the role of dysbiosis in oral microbiome due to tobacco consumption in the progression of the disease

Knezevich, A., Muzic, J., Hatsukami, D

Cigarette smoke impacts immune inflammatory responses to influenza in mice

A study published in The Lancet Global Health in 2023 estimated the macroeconomic burden of COPD in 204 countries and regions from 2020 to 2050, predicting a global economic loss of $4.326 trillion due to COPD, with China bearing the highest burden at $1.363 trillion [5]

However, that isnt necessarily the big, deciding factor

The spitting part is a hell of a lot of fun once you get the hang of it