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Cigarette smoking increases the risk of GD and complicates its extra thyroidal manifestations through direct cell damage, downregulation of the innate immune system, and induction of epigenetic changes (27-31)

Gupta S, Mortensen MS, Schjrring S, Trivedi U, Vestergaard G, Stokholm J, et al

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Together with our reporter analysis (Table 1, see Additional file 2: Figure S3), this suggests that while some genes are more broadly required for stress-induced phase 2 detoxification gene expression, others may be specifically required for the stress-induced expression of gcs-1 (Figure 2B,C)

5,31 These residual toxic effects will likely continue to negatively impact neurology until they can be removed