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One factor that did make a difference was smoking status

doi: 10.1016/j.jaci.2016.07.034 41 DongY.MoX.HuY.QiX.JiangF.JiangZ.et al

Smoking is one of the reasons behind the loss of lingual papillae (normally present on the upper surface of the tongue) which causes median rhomboid glossitis

Cigarettes are wrapped in paper and typically contain processed tobacco blends designed for inhalation

Romain Gary penned the wildly romantic novel in 1960 based on his mothers life of self-sacrifice raising him in Vilnius (then part of Russia) in the early years of the 20th century

Vapes, which may also be called vape pens, vaporizers, e-cigarettes, and e-hookahs, are battery-powered gadgets that heat a substance and turn it into an aerosol form that can be inhaled