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According to the Global Burden of Disease, in 2019, 3.28 million people died from Chronic Obstructive Pulmonary Disease (COPD), ranking as the third leading cause of death worldwide.1,2 In Spain, COPD is considered the fifth leading cause of death in men and the seventh in women.3 In 2017, the prevalence of COPD in Spain was estimated at 11.8% in population aged 40 years and over.4 Tobacco consumption is the main risk factor for COPD5 and usually COPD caused by it is initiated by lung injury and abnormal lung repair processes.6 Aspects related to tobacco consumption such as duration, intensity, accumulated consumption, age of initiation or years of abstinence can influence the risk of developing this disease

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And the adult smoking rate in the town is now 8%, compared with 18.1% statewide

However, HBx protein has its defense mechanism by directly binding to MDM2 and promoting MDM2 translocation into the nucleus to antagonize p53 transcriptional activity 68