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A randomized trial in the European Respiratory Journal even found that giving smokers a nicotinefree, cigarettelike inhaler to use as part of a structured quit program improved quit rates and helped with cravings, supporting the idea that keeping the ritual while removing nicotine can make this final transition more sustainable

Apparently the word is of uncertain derivation, but was coined in San Francisco and Sacramento, California in the mid-1800s

Although rates of smoking have decreased over time from 28.3% in 2009 to 18.5% in 2021 1,2 , smoking prevalence in the Philippines remains one of the highest in the Western Pacific region 3

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