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The exact cause of costochondritis is unknown, but it is often associated with physical strain or injury, repeated coughing, or respiratory tract infections like bronchitis or pneumonia

I highly recommend reading Proctor (2012) for further information, but in general the scientific evidence from the 1930s to the 1950s was accumulating in four areas of research: Population studies people who smoked had higher rates of lung cancer Animal studies tobacco caused tumors in model organisms Cellular pathology cigarette smoke was shown to deaden the hairlike cilia in the lungs upper airway Cancer-causing chemicals in cigarettes cigarette smoke contained polycyclic aromatic hydrocarbons (PAHs), which had been previously shown to cause cancer in people exposed to coal tar Multiple lines of evidence converging like this, linking a health effect with a specific factor, is one of the important ways that epidemiologists assess whether an exposure like smoking a cigarette can cause a detrimental health outcome

Of course they would want to welcome him back

A reel-to-reel tape recording of Kurtz's voice is played: I watched a snail crawl along the edge of a straight razor