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More than 480,000 Americans die from smoking and secondhand smoke exposure every year , according to the Centers for Disease Control and Preventionmore than died on the battlefields of World War I, World War II, Korea, and Vietnam combined

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The data implied that while smoke exposure induced microbiota disruption and emphysema, structural lung damage alone did not maintain the altered microbiota, indicating that microbial shifts might not directly contribute to emphysema progression [86]