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Dawson, How Good Intentions Contributed to Bad Outcomes: The Opioid Crisis, Journal of Mayo Clinic Proceedings 93 (2018): 345

The health effects of tobacco addiction include bad breath, weight loss, reduced stamina, increased risk of heart disease, cancer of the lungs or throat, infertility, and chronic obstructive pulmonary disease (COPD)

Using similar trajectory analyses, Karp and coworkers (2005) found that among novice smokers (mean age = 13 years), only one-fourth reported rapid escalation toward patterns of heavier use