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Causes / Risk Factors: Smoking (most common cause) Air pollution Occupational exposure (dust, fumes) Alpha-1 antitrypsin deficiency (genetic cause) Chronic bronchitis association Symptoms: Shortness of breath (especially on exertion) Chronic cough Wheezing Fatigue Barrel-shaped chest (due to hyperinflation) Weight loss (in advanced cases) Types of Emphysema: 1

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Nationally, the rate was 6.0%.2 Other tobacco product use: Maryland Vaping rates in Maryland In 2018, 4.3% of adults in Maryland used e-cigarettes and 2.0% used smokeless tobacco.3 In 2019, 23.0% of high school students in Maryland used electronic vapor products on at least one day in the past 30 days

This is why a relit cigar, especially one revisited a day later, cannot fully replicate its original flavor profile