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The flu alone results in an estimated annual cost of $11.2 billion in direct and indirect expenses in the U.S., and pneumonia healthcare costs range from $2,177 to $3,478 per adult

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Thus, smoking exacerbates the already high health risks posed by obesity and diabetes (often called diabesity)

Because these irritants are common constituents in TS, the authors hypothesised that they might contribute to the cough associated with smoke inhalation