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This deceptive lack of overt clinical symptoms means the disease process is frequently allowed to advance unchecked, eroding the deeper supporting bone structure without the obvious warning signs present in non-smokers

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The authors, to their credit, implicitly recognized this was almost certainly an artifact of the more dedicated (heavier, less inclined to quit) smokers being more likely to get such a recommendation (known as confounding by indication)

2016 [cited 24 January 2023]

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Health practitioners also collect patients medical history and other details about their symptoms, medication use, and lifestyle factors, such as cigarette smoking