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The diaphragm can also become weak or damaged, making it difficult to breathe

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6 However, the total economic impact of smoking in the United States has been estimated to exceed $200 billion in current dollars when considering direct costs (ie, inpatient care, outpatient visits, drugs, and diagnostic tests as well as transportation costs), indirect costs (ie, productivity loss, the cost of premature retirement, and morbidity costs), and intangible costs (difficult-to-monetize consequences as pain and suffering and emotional well-being) associated with smoking