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LITERATURE REVIEW 1) Cigarette smoking effects on the respiratory epithelium The epithelium coating the upper respiratory tract acts as a first line of defense against invasive agents (pollutants, allergens, microorganisms), and it can cause upper airway symptoms and diseases when in contact with these agents.5 Inhaled cigarette smoke, both passively as well as actively, has been associated with chronic irritation and discomfort on the eyes, nose and oropharynx.6 Since 1964, when a report was published about smoking by the U.S

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41 When considering England in isolation, 1% of this age group used pouches in 2019