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There is a wide range of rates in different states

its qualities are those which have made the pipe a symbol of peace and a bond of fellowship and union between man and man from Pole to Pole

Microbial colonization of the lower airway may be shaped by smoking in asthma, accordingly, some of the increased risk and severity of pulmonary disorders in tobacco smokers with asthma [103] could still be mediated through smoking-induced changes in the lung microbiome

The data implied that while smoke exposure induced microbiota disruption and emphysema, structural lung damage alone did not maintain the altered microbiota, indicating that microbial shifts might not directly contribute to emphysema progression [86]