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And all of the things kept coming back. It all came to a head on Goggins last night of shooting, which took place in Bangkok on the banks of the Chao Phraya River

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This review summarizes results from studies of humans, preclinical animal models, and cultured endothelial cells that document toxicities of cigarette smoke exposure on pulmonary endothelial cell functions, including barrier dysfunction, endothelial activation and inflammation, apoptosis, and vasoactive mediator production

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If the smoking status is already documented, it can be asked: I see from your notes that youre a smoker, are you still smoking? If they are recorded as ex-smokers, it is vital to re-check as approximately 70% of ex-smokers will eventually relapse within a few years, further questions that can be used are: According to your records you quit smoking, how are you getting on with that? When advising it is important to take the perspective of educating not judging or coercing, for example: Ok, I am not sure whether you are aware, but there are several negative consequences to you and your baby of smoking during pregnancy, and it is entirely your choice, but we know that the best way to stop is with extra support, which is available in the NHS

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