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Exposure to tobacco smoke has been shown to alter both innate and adaptive immune responses, including disruption of T-cell differentiation, promotion of pro-inflammatory cytokine production, and impairment of immune regulatory pathways ( At the molecular level, mechanisms of immunosenescence are the result of genomic instability, accumulation of damage, and epigenetic modifications that trace back to the most foundational units of self - DNA ( At the cellular level, a central feature of immunosenescence is the decline in nave T-cell production as thymic involution progresses with age