Animal and human studies have demonstrated that Nrf2/Keap-1 and their target genes protect against inflammation and oxidative stress from cigarette smoke (Kensler et al. 2007; Boutten et al. 2011), with Nrf2 disruption in mice leading to increased cigarette smoking-induced emphysema (Rangasamy et al. 2004; Cui et al. 2018). This evidence concerns the gene KEAP1 and pulmonary emphysema.