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Selective selection of studies Professor Peter Shields, Emeritus Professor of Medical Oncology at Ohio State University, notes that Bernard Stewart's report does not really add anything new

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The process transforms raw cured leaves into a smoother, more aromatic material suitable for cigarette manufacturing

Future clinical studies should systematically take into account not only the psychosocial stress and smoking status, which are the classic confounding factors in periodontitis, but should also consider the patients diet and medications

Weichhart T, Semann MD

Directly, many substances in cigarette smoke possess cytotoxic properties that induce oxidative stress, a critical pathway in liver injury and fibrosis [5]