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The effect of cigarette smoking on CKD is proportional to the Brinkman index, and the clearance effect takes several decades, which is more similar to cancer than it is to CVD (see Figure 2)

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Maintaining a good oral hygiene routine by brushing at least twice a day, flossing each night before brushing and using anantiseptic mouthwash can help to prevent heavy staining and tar build-up, but it will not completely protect your teeth from discoloration caused by tobacco use

For a current smoker with COPD and no documented linkage, assign codes J44.9, Chronic obstructive pulmonary disease, unspecified and F17.210, Nicotine dependence, cigarettes, uncomplicated