cigarettes and copd is mainly associated with cigarette/biomass smoke CDC - Health Effects -

As a result they will inhale at least as many harmful substances as with cigarettes without ventilation holes

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Further research is needed to quantify these effects for specific diseases, but this study shows that commonly used measures may give rise to disparities in access to lifesaving interventions. Holford found that while African Americans are less likely than whites to start smoking in their late teen years when most smoking habits start they are also less likely than whites to quit as they get older