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Typically, the disease emerges in adolescents or young adults (239)

Acetaldehyde, a component of cigarette smoke and metabolic product of alcohol breakdown, has epigenetic and genetic toxic effects (Shukla and Lim, 2013) and can inhibit key mitochondrial reactions and functions ( High levels of these reactive aldehydes form adducts on macromolecules present in the lungs, leading to an inflammatory response

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In 1947, Max Ponty refined the figure to a silhouette to create an image that is still in use today on the Gitanes Blonde packet