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Smoking and Homoeopathy

© Dr. Rajneesh Kumar Sharma M.D. (Homoeopathy)

Dr. Deepika Vishwakarma BHMS

Homoeo Cure & Research Institute

NH 74, Moradabad Road, Kashipur (Uttaranchal) INDIA

Pin- 244713 Ph. 05947- 260327, 9897618594

  1. mail-



For well formatted and illustrated article, please see attached file-

Smoking and Homoeopathy.pdf


Definition. 2

Causes. 2

Genetic factors. 2

Sociodemographic factors. 2

Environmental factors. 2

Behavioral factors. 2

Personal factors. 2

Pathology. 2

Mainstream smoke. 2

Side stream smoke. 2

Composition of tobacco smoke. 2

Signs and symptoms. 4

Heart and blood vessels. 4

Cardiovascular disease. 4

Cancer. 4

Genotoxic effect. 4

Lungs. 4

Kidney. 5

Infections. 5

Skin. 5

Sexual dysfunction. 5

Smoker’s Face. 5

Treatment. 5

Smoking cessation. 5

Homoeopathic remedies to cease smoking. 6

Short repertory of smoking. 6

Bibliography. 10



Smoking is process of inhaling burned chemical substances, collectively called as tobacco, into the lungs through cigarettes, pipes, cigars, hookahs etc. where they are rapidly absorbed into the bloodstream and reach different body tissues, generating the sensation of pleasure, relaxation, and satisfaction. (Psora/ Syphilis)


The genetic, sociodemographic, environmental and behavioral factors as well as specific dimensions of personality are responsible for developing the smoking habit. (Psora/ Syphilis)

Genetic factors

Genetic factors greatly contribute to major personality characteristics and may be a cause for habit of smoking. (Syphilis)

Sociodemographic factors

The earlier in life smoking is started the higher the likelihood of becoming a regular smoker. Higher smoking rates in females are frequently found in countries with a Western lifestyle. Ethnic background is a major determinant of smoking status, with lower prevalence in Blacks than in Hispanics and lower relative frequencies of smoking in Northern than in Southern Europe. Parental socioeconomic status is generally inversely related to smoking in adolescents. (Psora)

Environmental factors

Children of smokers have a higher risk of taking up the habit. The proper parenting is inversely related to rates of smoking intention, initiation and experimentation in adolescents. (Psora, Causa occasionalis)

Behavioral factors

Good academic performance in school is a major predictor for nonsmoking among teenagers. The smokers are generally more prone to potentially dangerous habits. (Psora)

Personal factors

The stress is associated with initiation and maintenance of smoking. (Psora)


In cigarette smoke, matter is dispersed in the gas phase in two ways-

Mainstream smoke

During puffing, mainstream smoke emerges from the mouthpiece. It contains about 95% gases and rest the particles.

Side stream smoke

It is emitted between the puffs at the burning cone and from the mouthpiece.

Composition of tobacco smoke

Cigarette smoke is a heterogenous aerosol produced by incomplete combustion of the tobacco leaves. More than 4,000 substances have been identified in cigarette smoke, including some that are pharmacologically active, antigenic, cytotoxic, mutagenic, and carcinogenic. Nicotine is not one of them. The inhaled nicotine binds to nicotine acetylcholine receptors in the brain as it is similar to endorphins and dopamine leading to sensations of pleasure, relaxation, and satisfaction. (Psora)

Selected constituents of cigarette smoke

Particulate phase

Main effects

Gas phase

Main effects



Carbon monoxide

Impairment of oxygen binding to haemoglobin


Dose-dependent stimulator or depressor of parasympathetic N-cholinergic receptors

Oxides of nitrogen

Irritant, pro-inflammatory, ciliotoxic

Aromatic hydrocarbons



Irritant, pro-inflammatory, ciliotoxic


Irritant, mutagenic/carcinogenic

Hydrocyanic acid

Irritant, pro-inflammatory, ciliotoxic


Irritant, mutagenic/carcinogenic


Irritant, pro-inflammatory, ciliotoxic




Irritant, pro-inflammatory, ciliotoxic










Tumor acceleration

Vinyl chloride



Tumor acceleration



Cigarette smoke contains a high concentration of reactive organic radicals (RORs) and substances capable of producing RORs. Free radicals are formed in high amounts at the tip of the cigarette due to the high temperatures. Highly reactive free radicals are formed continuously within the smoke by chemical processes during inhalation. An important source for radical production is the relatively stable nitric oxide (NO) radical that is found in cigarette smoke in high concentrations. NO is oxidized to the more reactive nitrogen dioxide radical by dioxygen. This radical reacts with isoprene that has been demonstrated in high concentrations in cigarette smoke to form various biologically active RORs.

The incomplete combustion produced by tobacco produces carbon monoxide, which impairs the total oxygen-carrying capacity of hemoglobin.

Cell injury and tissue destruction by Reactive organic radicals (RORs)

DNA- deoxyribonucleic acid, NF- nuclear factor, AP- activator proteins

Signs and symptoms

Smoking is one of the leading causes of preventable death globally. This is among the leading causes of many diseases such as lung cancer, heart attacks, COPD, erectile dysfunction, Alzheimer's disease, vascular stenosis and birth defects, like ADHD to a fetus. Main symptoms of nicotinism are-

  • Agitation
  • Confusion
  • Restlessness
  • Palpitations
  • Hypertension
  • Dilated pupils
  • SOB (shortness of breath)
  • Abdominal cramps
  • Vomiting

Smoking can damage every part of the body. It affects different systems of the body as below-

Heart and blood vessels

  • Within one minute the heart rate begins to rise, increasing by as much as 30 percent during the first 10 minutes of smoking
  • Blood pressure increases
  • Several ingredients of tobacco lead to the narrowing and weakening of blood vessels, increasing the likelihood of a blockage, and thus a heart attack or stroke

Cardiovascular disease

  • Raises the levels of fibrinogen and increases platelet production
  • Linked to Berger’s disease (thromboangiitis obliterans)
  • Acute inflammation and thrombosis of arteries and vines of the hands and feet like DVT
  • Tends to increase blood cholesterol levels, developing various forms of arteriosclerosis
  • May lead to a myocardial infarction


  • Particularly lung cancer (90%), kidney, larynx, bladder cancer, esophagus, pancreas and stomach cancer

Genotoxic effect

  • Acrolein- binds to guanidine in DNA- mutagenic and carcinogenic effects
  • Polynuclear aromatic hydrocarbon- epoxide causes genetic mutation
  • Nitrosamine- carcinogenic effects


Carbon monoxide is responsible for pulmonary damage and for loss of elasticity in the alveoli, causing-

  • Emphysema
  • Chronic bronchitis
  • Chronic Obstructive Pulmonary disease
  • Interstitial lung diseases (ILDs)- represent a heterogenous group of lung disorders, generally characterized by dyspnoea, dry cough, diffuse interstitial infiltrates, restrictive lung function pattern, and impaired gas exchange, like sarcoidosis, idiopathic pulmonary fibrosis (IPF), pneumoconiosis, and ILDs associated with connective tissue diseases.
  • Hypersensitivity pneumonitis (HP) or extrinsic allergic alveolitis- is a chronic inflammatory lung disease caused by inhalation of organic dust including antigens typically derived from animal proteins or microbes.


  • Smoking encourages the progression of diabetic nephropathy


  • Smoking increases the risk pulmonary and respiratory tract infections both through structural damage and through effects on the immune system


  • Premature skin aging

Sexual dysfunction

  • Loss of sexual activity, mainly in men

Smoker’s Face

  • Describes the characteristic changes that happen to the faces of many people who smoke. The general appearance is of accelerated aging of the face, with a characteristic pattern of facial wrinkling and sallow coloration.


The main goal of treatment is to stop smoking and treat the consequences of smoking.

Smoking cessation

There is scientific consensus that cigarette smoking is an addiction to the drug nicotine. As with any drug addiction, social, economic, personal and political influences play an important part in determining patterns of smoking prevalence and cessation. The following methods are available to cease smoking-

  • Self-help
  • Educational
  • Brief clinical interventions- physician advice and counselling
  • Clinics and groups
    • Voluntary agencies
    • Commercial programs
  • Pharmacotherapy
    • Nicotine replacement
      • Chewing gum
      • Transdermal systems
      • Nasal spray
      • Inhaler
    • Bupropion
  • Behavioral
  • Hypnosis
  • Acupuncture
  • Homoeopathy

Homoeopathic remedies to cease smoking

Abies-n. abrom-a. acon-l. acon. act-sp. agar. Agarin. agn. aloe alum-p. Alum. Alumn. am-c. ambr. amp. anac. androc. ang. Ant-c. Ant-t. apoc. aral. aran-ix. Aran. arg-met. Arg-n. arn. ars-h. ars-i. ARS. asar. Asc-t. aur-m-n. bamb-a. Bell. borx. bov. Brom. brucel. Bry. cact. caj. CALAD. calc-caust. calc-i. Calc-p. CALC. Camph. cann-i. Canth. Carb-ac. CARB-AN. carb-v. carbn-s. card-m. Casc. castor-eq. Caust. cham. chel. chen-a. CHIN. chinin-ar. chinin-m. chir-fl. chlol. chlor. cic. cimic. Clem. coc-c. Coca cocc-s. Cocc. Coff. coloc. con. conv. crot-h. cupr. Cycl. cygn-be. Daph. des-ac. dig. dor. dream-p. Dros. dulc. elaps eug. Euphr. falco-pe. ferr-i. ferr. galla-q-r. Gels. ger-i. gink-b. glon. granit-m. grat. haliae-lc. ham. Hell. Hep. hera. hippoc-k. hydr. hydrc. hydrog. Hyper. iber. ictod. IGN. ina-i. iod. Ip. irid-met. jug-r. kali-bi. kali-br. kali-c. kali-n. kali-p. kali-s. kalm. Kola kreos. Lac-ac. Lach. led. levo. lil-t. Lob. Lyc. lycpr. lycps-v. lyss. M-ambo. m-arct. Mag-c. mag-m. mag-s. manc. mand. med. melal-alt. menth. Meny. meph. merc. mez. mur-ac. naja narz. NAT-AR. Nat-c. Nat-m. Nat-s. nat-sil. nep. nicc. nicot. nit-ac. nux-m. NUX-V. okou. ol-an. Olib-sac. olnd. Oncor-t. Op. osm. ox-ac. oxal-a. pall. Par. paraf. pegan-ha. petr. phasco-ci. Phos. phys. phyt. pilo. pin-con. PLAN. plat. plb-act. plb. podo. Positr. psil. psor. PULS. pycnop-sa. rad-br. ran-b. raph. rhod. rhus-t. Ruta sabad. sabin. sal-fr. sang. saroth. sars. scop. scut. sec. Sel. seneg. Sep. sil. sol-mm. sol-ni. SPIG. SPONG. squil. stann. STAPH. stel. strept-ent. stront-c. stroph-h. stry. succ-ac. suis-em. sul-ac. Sulph. symph. TAB. Tama. taosc. Tarax. tarent. tell. Teucr. thal. ther. thiop. Thuj. thymol. til. tritic-vg. tub. v-a-b. valer. vanil. verat. vip. zinc. zing.

Short repertory of smoking

ABDOMEN - DIARRHEA - tobacco; after smoking borx.

ABDOMEN - PAIN - tobacco; after - amel. coloc.

ABDOMEN - PAIN - tobacco; after asc-t. borx. brom. ign. spig.

CHEST - ANGINA pectoris - tobacco; from calad. conv. kalm. lil-t. nux-v. spig. staph. tab.

CHEST - ARTERIOSCLEROSIS of coronaries - tobacco; from tab.

CHEST - PAIN - Heart - tobacco; from kalm. lil-t. nux-v. spig. staph. tab.

CHEST - PALPITATION of heart - irritable heart - tobacco; from dig. stroph-h.

CHEST - PALPITATION of heart - tobacco from - young men; in neurotic agn.

CHEST - PALPITATION of heart - tobacco from acon. agar. Agarin. agn. ars. cact. calad. conv. dig. Gels. iber. Kalm. lycps-v. Nux-v. olib-sac. phos. Spig. spong. staph. Stroph-h. tab. thuj. verat.

CHEST - TOBACCO heart - cigarettes; especially conv.

CHEST - TOBACCO heart apoc. cact. calad. conv. kalm. saroth. scop. scut.

COUGH - TOBACCO smoke - agg. acon. arg-n. brom. bry. carb-an. clem. coc-c. coloc. dros. dulc. euphr. ferr. hep. ign. iod. irid-met. Lach. mag-c. menth. merc. nux-v. petr. spong. staph. sul-ac. thuj.

EAR - PAIN - tobacco; from raph.

EXPECTORATION - TASTE - tobacco juice, like Puls.

EXTREMITIES - TREMBLING - Hands - tobacco; from Nux-v.

EYE - ATROPHY - Optic nerve - tobacco; from ars. nux-v.

EYE - ATROPHY - Retina - tobacco; from nux-v.

EYE - TOBACCO agg. dig.

FACE - CANCER - Lips - tobacco; from con.

FACE - PAIN - tobacco; from ign. sep. spig.

FEVER - TOBACCO smoking cic. ign. sep.

GENERALS - CONVALESCENCE; ailments during - nicotine; after abuse of  nux-v.

GENERALS - CONVULSIONS - tobacco swallowing, from ip.

GENERALS - NEUROLOGICAL complaints - tobacco; from - sedentary habits; in persons with sep.

GENERALS - NEUROLOGICAL complaints - tobacco; from gels.

GENERALS - ORGASM of BLOOD - smoking tobacco, on phos.

GENERALS - PARALYSIS - nicotinism, from nux-v.

GENERALS - TETANUS - tobacco; from swallowing ip.

GENERALS - TOBACCO - agg. - boys; in arg-n. ars. verat.

GENERALS - TOBACCO - agg. - nicotinism - accompanied by - Tongue; cracked nux-v.

GENERALS - TOBACCO - agg. – nicotinism ign. nux-v. okou. tab.

GENERALS - TOBACCO - agg. - smell of Asc-t. gink-b. osm.

GENERALS - TOBACCO - agg. - smoke of tobacco; by acon. alum. aran. brom. cic. cocc. ferr-i. ign. staph.

GENERALS - TOBACCO - agg. - smoking, when breaking of calad. led.

GENERALS - TOBACCO - agg. Abies-n. acon. act-sp. agar. Alum. Alumn. ambr. amp. anac. ang. Ant-c. aral. arg-met. arg-n. arn. ars-i. ARS. asc-t. aur-m-n. bell. borx. brom. Bry. cact. caj. Calad. calc-caust. calc-p. calc. camph. cann-i. carb-an. carbn-s. caust. cham. chel. chin. chinin-ar. chinin-m. cic. Clem. coc-c. coca Cocc. Coff. coloc. con. conv. cupr. Cycl. dig. dor. Dros. Euphr. ferr-i. ferr. Gels. granit-m. ham. Hell. hep. hydr. iber. ictod. IGN. ina-i. iod. Ip. kali-bi. kali-br. kalm. lac-ac. Lach. lob. Lyc. M-ambo. m-arct. Mag-c. mag-m. mand. Meny. merc. mur-ac. naja NAT-AR. nat-c. Nat-m. nep. nicot. NUX-V. okou. osm. Par. paraf. petr. phasco-ci. Phos. PLAN. plb. psil. PULS. rad-br. ran-b. rhus-t. Ruta sabad. sabin. sars. scut. sec. Sel. seneg. sep. sil. sol-mm. SPIG. SPONG. stann. STAPH. stel. strept-ent. stront-c. stroph-h. succ-ac. sul-ac. sulph. tab. Tama. Tarax. Thuj. verat. zinc.

GENERALS - TOBACCO - amel. - smell of lycps-v.

GENERALS - TOBACCO - amel. aran-ix. aran. arn. borx. carb-ac. coloc. Hep. levo. lycpr. melal-alt. merc. naja nat-c. Nat-s. plat. Sep. spig. stront-c. tarent.

GENERALS - TOBACCO - aversion to – cigarettes Oncor-t. v-a-b.

GENERALS - TOBACCO - aversion to – morning meph. positr.

GENERALS - TOBACCO - aversion to - smell of tobacco; sensitive to agar. ars-h. Asc-t. Bell. Casc. chin. elaps gink-b. Ign. Lac-ac. Lob. Lyc. lyss. Nux-v. phos. Puls. sol-ni. spig. symph. tab.

GENERALS - TOBACCO - aversion to - smoking his accustomed cigar - breakfast; after psor.

GENERALS - TOBACCO - aversion to - smoking his accustomed cigar - in spite of his distaste for tobacco; smokes much thiop.

GENERALS - TOBACCO - aversion to - smoking his accustomed cigar – morning ox-ac.

GENERALS - TOBACCO - aversion to - smoking his accustomed cigar – forenoon kali-bi.

GENERALS - TOBACCO - aversion to - smoking his accustomed cigar – afternoon ign.

GENERALS - TOBACCO - aversion to - smoking his accustomed cigar – evening Arg-n.

GENERALS - TOBACCO - aversion to - smoking his accustomed cigar alum-p. alum. alumn. ant-t. arg-met. Arn. asar. borx. Brom. bry. calc-p. Calc. Camph. carb-an. Casc. chen-a. clem. coc-c. coff. con. euphr. ferr-i. ferr. gink-b. grat. haliae-lc. IGN. jug-r. kali-bi. kali-n. lach. led. lil-t. Lyc. mag-s. nat-ar. nat-m. nat-s. nat-sil. nicc. Nux-v. olnd. op. ox-ac. phos. plat. positr. psor. Puls. sars. sep. spig. Sulph. symph. tarax. tell. v-a-b. vip.

GENERALS - TOBACCO - aversion to – snuff spig.

GENERALS - TOBACCO - aversion to abrom-a. acon-l. acon. alum-p. alum. androc. ant-t. arg-met. arg-n. arn. ars. asar. asc-t. bell. borx. bov. brom. bry. CALC. Camph. Canth. Carb-an. chen-a. chin. chlol. chlor. cimic. clem. coc-c. cocc. coff. con. crot-h. dream-p. ger-i. gink-b. grat. hera. hydrc. hydrog. Ign. ip. jug-r. kali-bi. Lach. led. Lob. Lyc. m-ambo. mag-s. mand. meph. mez. nat-ar. Nat-c. Nat-m. nep. nux-m. NUX-V. olnd. Op. oxal-a. par. paraf. Phos. phys. phyt. plan. plat. positr. psor. Puls. rhus-t. sars. sep. sil. spig. stann. staph. stry. suis-em. Sulph. symph. tarax. thal. thuj. til. v-a-b. valer. zing.

GENERALS - TOBACCO - chewing tobacco; from ARS. carb-v. ign. lyc. Nux-v. Plan. sel. tab. verat.

GENERALS - TOBACCO - desire for tobacco - dinner; after nat-c. tritic-vg.

GENERALS - TOBACCO - desire for tobacco – evening ox-ac.

GENERALS - TOBACCO - desire for tobacco - smoking; desire for androc. bamb-a. calad. calc-p. carb-ac. carb-an. card-m. castor-eq. coff. daph. des-ac. eug. Glon. ham. kali-p. Kola lach. led. lyc. m-ambo. med. nat-c. nux-v. olib-sac. pegan-ha. phasco-ci. Positr. pycnop-sa. sep. staph. taosc. ther. til. tritic-vg. tub. vanil.

GENERALS - TOBACCO - desire for tobacco – snuff Bell. sil.

GENERALS - TOBACCO - desire for tobacco acon-l. aran-ix. Ars. asar. bell. brucel. calad. Calc-p. Camph. carb-ac. carb-v. card-m. castor-eq. Chin. chir-fl. chlor. Coca coff. con. cygn-be. daph. dulc. eug. falco-pe. galla-q-r. glon. granit-m. ham. hydrog. ictod. kali-s. kreos. lyss. m-ambo. manc. med. melal-alt. narz. nat-c. nicot. nux-v. Olib-sac. ox-ac. pall. Phos. pin-con. plan. plat. plb. positr. rhus-t. sal-fr. Spig. spong. Staph. TAB. Tama. ther. thiop. thuj. tritic-vg. vanil.

GENERALS - TOBACCO - disgust for tobacco; remedies to increase arg-n. ars. calad. calc. camph. CARB-AN. Caust. con. Daph. ign. lach. nep. nicot. nux-v. pall. petr. plan. STAPH. stry. sulph. tab. v-a-b.

GENERALS - WEAKNESS - tobacco; from calad. clem. granit-m. hep. nux-v.

LARYNX AND TRACHEA - PAIN - Larynx - tobacco smoking, from bry.

LARYNX AND TRACHEA - TICKLING - Air passages – tobacco acon.


LARYNX AND TRACHEA - VOICE - lost - tobacco; by strept-ent.

MALE GENITALIA/SEX - ERECTIONS - wanting - accompanied by - tobacco; desire for CALAD.

MALE GENITALIA/SEX - ERECTIONS - wanting - tobacco; from abuse of calad. lyc.

MIND - ANXIETY - tobacco, from smoking petr. sep. symph.

MIND - DELUSIONS - intoxicated - is; he - tobacco smoking; as after spig.

MIND - DELUSIONS - tobacco - vertigo were from tobacco rhod.

MIND - FORGETFUL - tobacco poisoning, from Calad.

MIND - PROSTRATION of mind - tobacco; from calad.

MIND - SADNESS - tobacco, after abuse of plan.

MIND - TOBACCO - amel. chir-fl.

MOUTH - PAIN - Palate - tobacco - biting pain chin.

MOUTH - PAIN - Tongue - tobacco; from - biting pain anac. cocc-s. nep.

MOUTH - TASTE - acrid - tobacco tastes chin. m-ambo. spong. stann. staph.

MOUTH - TASTE - acute - tobacco; of  coff.

MOUTH - TASTE - bad - tobacco tastes Calc.

MOUTH - TASTE - biting - tobacco tastes anac.

MOUTH - TASTE - bitter - tobacco - amel. calc-i.

MOUTH - TASTE - bitter - tobacco – tastes anac. asar. Camph. CHIN. Cocc. Euphr. ign. m-arct. nat-m. Phos. puls. Spong.

MOUTH - TASTE - dry – tobacco stann.

MOUTH - TASTE - good - tobacco; of coff. plb.

MOUTH - TASTE - metallic - tobacco tastes kali-bi. kali-c.

MOUTH - TASTE - musty – tobacco rhus-t. Teucr. thuj.

MOUTH - TASTE - nauseous - tobacco tastes Ip.

MOUTH - TASTE - offensive - tobacco tastes camph. ip. sel.

MOUTH - TASTE - pasty - tobacco tastes staph.

MOUTH - TASTE - pungent – tobacco chin. staph.

MOUTH - TASTE - sour – tobacco staph.

MOUTH - TASTE - straw, like - tobacco tastes mez.

MOUTH - TASTE - strong; too – tobacco Coff.

MOUTH - TASTE - sweetish - tobacco tastes chin. dig. kali-bi. sang. sars. sel.

MOUTH - TASTE - tobacco, juice, as from gink-b. nat-c. positr.

MOUTH - TASTE - wanting, tastelessness of food – tobacco anac. ant-t. chin. ign. m-arct. nux-v. puls. squil.

NOSE - ODORS; imaginary and real – tobacco puls.

NOSE - SMELL - acute – tobacco bamb-a. Bell. chin. hippoc-k. Ign. kali-s. kola lyss. nat-sil. Nux-v. phos. podo. Puls. ruta

PROSTATE GLAND - EMISSION of prostatic fluid - tobacco agg. daph.

RECTUM - CONSTIPATION - tobacco; from tab.

RECTUM - DIARRHEA - tobacco; from borx. brom. cham. ign. puls. tab.

RESPIRATION - TOBACCO agg. aloe tarax.

SLEEP - SLEEPLESSNESS - tobacco; after abuse of gels. nux-v. plan.

STOMACH - ERUCTATIONS - tobacco; from Sel. thymol.

STOMACH - ERUCTATIONS; TYPE OF - water brash - tobacco - amel. ol-an.

STOMACH - HEARTBURN - tobacco; from  chel. staph. tarax. thymol.

STOMACH - INDIGESTION - tobacco; after abies-n. Nux-v. sep.

STOMACH - NAUSEA - tobacco - odor of Carb-an. ign. oncor-t. phos.

STOMACH - NAUSEA - tobacco - thought of kali-br.

STOMACH - SENSITIVENESS - tobacco; to asc-t. ign.

STOOL - TOBACCO; from abuse of cham. PULS.

TEETH - PAIN - tobacco; from chewing Bry.

THROAT - SCRAPING - tobacco; from osm.

URINE - ODOR - tobacco, like nit-ac. tab.

VERTIGO - TOBACCO agg. – snuff sil.

VERTIGO - TOBACCO agg. borx. con. rhod. sil. zinc.

VISION - LOSS OF VISION – tobacco ars. nux-v. phos. pilo. plb-act.


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 Tobacco Use Behavioral Medicine: A Guide for Clinical Practice, 4e

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