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Researchers Say It Takes Genes, Viruses and Cigarettes Physicians say that smoking is by far the biggest cause of emphysema, but why doesn't every smoker get the disease? If you asked Michael Holtzman, M.D., that question, he might answer that for most cases of emphysema you need a mix of genes, viruses and cigarettes. Emphysema and the associated condition of chronic … [Read more...] about Why Doesn’t Every Smoker Get Emphysema?