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Having an autoimmune disease means that your bodys immune system mistakenly attacks healthy tissue in your body

Reference Fowles44 Several studies have shown that smoking in adolescents and adults with bipolar disorder is associated with earlier age at onset of mood disorder, greater severity of symptoms, Reference Heffner, Anthenelli, Adler, Strakowski, Beavers and DelBello46Reference Medeiros, Lafer, Kapczinski, Miranda-Scippa and Almeida51 poorer functioning, comorbid substance misuse, Reference Wilens, Biederman, Martelon, Zulauf, Anderson and Carrellas52 suicide attempts Reference Ducasse, Jaussent, Guillaume, Azorin, Bellivier and Belzeaux53 and other adverse outcomes, such as readmission to hospital

However, some of this damage to fertility may be dose-dependent , i.e., the number of cigarettes a woman smokes per day

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