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"If only the FDA had done its job as a regulator, promulgating rules that promote compliance, a vibrant above-board market, and public health, an entire industry would not face extinction, the illicit market would have been kept at bay, and FDA itself would not be dealing with a paperwork nightmare." Still, the root of the problem is the regulatory standard decreed by Congress

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Additionally, smoking and tumor-related factors increase the production of immunosuppressive cytokines such as transforming growth factor-beta (TGF-) and interleukins (IL-4, IL-6, IL-10)

Most diabetics who smoke require higher doses of insulin to control their blood sugar