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I believe it is less to do with tobacco and more to do with having something in your hand/mouth

It uses a spirometer and a bronchodilator which assist in the diagnosis of asthma and COPD by measuring the reversibility with the help of an inhaled bronchodilator.Dr Rajesh Chawla Other tests may include a chest x-ray, CT scan, arterial blood gas analysis along with other laboratory tests which may help figure if they are any other complications

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