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Not only the relative risk, but also the severity of the orbitopathy was more in patients who smoked compared to those who did not.[] Multiple studies investigating for dose-response effect report a positive association of the severity of the GO with the duration and number of cigarettes smoked.[] In a comprehensive analysis, Pfeilschifter and Ziegler,[] reported a linear trend of increase in RR for orbitopathy in Graves' disease with increasing dose of smoking

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