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Abstract Tobacco smoking is the leading cause of disability and preventable deaths worldwide, but it should be differentiated from tobacco use disorder, which is, according to the Diagnostic and Statistical Manual of Mental Disorders, a bona fide mental disorder

they have resurrected a mood, an attitude, a way of moving through the world that feels deliberate yet nonchalant

Clinical trials indicate bethanechol is no more effective than placebo, and its use is associated with significant dose-dependent unpleasant side effects including blurred vision, bradycardia, bronchospasm, and GI upset (Barrett 1981