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Thus, the authors suggested that in a highly endemic TB setting with few tobacco smokers, worse disease severity or outcome due to smoking were not observed, but they highlighted the existence of confounding factors ( Another study, conducted in Taipei, sought to determine whether tobacco smoking increases the risk of TB relapse in adults who have successfully completed TB treatment, and the underlying factors

Hebels DG, Bried JJ, Khampang R, et al

(The practice returned the 1980s, among some American Indian Catholics, with burning tobacco and sweetgrass before Mass as their way of blending Native American beliefs and Catholic liturgy)