Afshar M, et al. - The link between tobacco use, inhalation injury, and ARDS in burn-injured adults was investigated in this study. Mediation analysis identified inhalation injury as the overwhelming predictor for ARDS development. Additionally, it was noted that via inhalation injury, tobacco use had its strongest effect indirectly. The ARDS risk was reported to be greatest among those with at least moderate inhalation injury despite baseline risk factors like tobacco use.