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I can definitely see the impact of smoking on my blood pressure / cardiovascular system, but it doesn’t affect MG for me. I only started smoking because I developed fibromyalgia about 6 months before the onset of MG (I had a positive ANA before studying abroad in Egypt — after that my body quickly fell apart, but it was a perfect storm / multifactorial). I’ve never used tobacco paper — just bowls & bongs. Given decades of chronic pain, I can wholeheartedly say I would not be here without it — especially with chronic overlapping pain conditions.
I’m still very curious though!!