Below is an instruction from Human. Write a response.
    ### Instruction:
    What causes Buerger disease ?
    ### Response:
    What causes Buerger disease? Buerger disease has a strong relationship to cigarette smoking. This association may be due to direct poisioning of cells from some component of tobacco, or by hypersensitivity to the same components. Many people with Buerger disease will show hypersensitivities to injection of tobacco extracts into their skin.
    