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While spirometric evidence of airflow obstruction is required to make a COPD diagnosis, spirometry is underutilized in clinical settings, 20,54,55 and the lack of spirometry in the PATH Study along with the potential of diagnostic and recall bias associated with self-report may introduce imprecision in the COPD diagnosis

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However, Billy & Me does not have Joels approval, rights to his music, or his life rights the latter essentially being an agreement studios strike to buy a persons permission to adapt their personal story without the threat of lawsuits

Unlike cigarette smoke, vapor doesn't soak into hair, skin, and clothing, so there's no lasting "smoker smell" to detect

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What are the environmental impacts of cigarette packaging