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The transition to a more severe expression of smoking-associated disease is marked by the impaired ability of macrophages to kill bacteria or viruses, the loss of ability to remove dead cells, the degradation and chemical modification of the extracellular matrix, the increasing retention of oligoclonally expanded CD8+ T cells and the induction of interleukin-17-secreting effector T cells

Mitochondrial dysfunction with loss of cytochrome c and changes in cellular redox status has been shown to alter TGF- signaling in fibroblasts, promoting fibrogenesis, and mitochondrial ROS can directly stimulate alveolar epithelial cell changes towards a profibrotic phenotype (Henderson and OReilly, 2021

If you smoke your first cigarette WITHIN 30 MINUTES of waking up, use Nicotine Polacrilex Gum, 4 mg