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It is unclear whether this association is due to confounding factors such as more sex partners among smokers compared with nonsmokers, or to a direct biologic effect through suppressed immune function in smokers (Holt 1987)

Myers and others point out that Texas budgeted only $10.2 million, or 2 percent of the $490 million payment to be used for anti-smoking efforts in 2016

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Sutfin EL, McCoy TP, Reboussin BA, Wagoner KG, Spangler J, Wolfson M: Prevalence and correlates of waterpipe tobacco smoking by college students in North Carolina