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Its social and cultural use is observed across the UK [footnote 23] , with some evidence that it is impacting on the risk of oral cancer [footnote 24] [footnote 25]

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In 2009, Cohen et al., also reported on the exposure of epithelia cell cultures to the particulate phase of cigarette smoke reducing cilliary beat increase when stimulated.13 Besides in vitro evidence, the exposure to cigarette smoke also harms mucociliary transport in humans, both in acute exposure14 as well as in its chronic counterpart.15,16 Cigarette smoking is also associated with profound changes in mucous production mechanisms

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