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when these blood vessels are damaged, the discs do not receive nourishment and this may speed up the degenerative process. While smoking has been associated with degeneration in the lumbar spine, this was one of the first studies to make the association with the cervical spine

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World Health Organization Study Group on Tobacco Regulation

Asking for a tobacco para liar and making hand gestures usually does the job of describing what you want, although it can get you in comical situations as well

Out of 27 population-level studies, 11 had a moderate risk of bias, nine had a serious risk of bias and seven had a critical risk of bias because of confounding evidence and bias in how the researchers reported the results