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Self-selection and confounding are important threats to internal validity

For instance, if the smoking rate in a neighborhood were to increase from 10.7% (the 10th percentile of all census tracts) to 27.6% (the 90th percentile), the prevalence of coronary heart disease would rise by 27%, asthma would jump by 39%, and chronic obstructive pulmonary disease would climb by 120%

If we take that viewpoint, its not such a big deal whether the teacher smokes or not

I think an e-cigarette is probably a safer product, because its just nicotine and some other flavorings that youre inhaling, said Nancy Rigotti, a Harvard School of Medicine professor specializing in tobacco-related disease

Being unique with the quality of its tobacco, filter, and packaging Line X is one of a kind amongst local cigarette brands