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Discussion In this nationwide population-based cohort with comprehensive data on health status and medical service utilization of the entire Korean population, smoking reduction and smoking cessation were independently associated with a lower risk of lung cancer development in patients with COPD who smoked less than 30 pack-years, after adjusting for major confounders, including cumulative smoking amount and sociodemographic factors

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This damage starts soon after you start smoking and gets worse as long as you continue to smoke