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Smoke can kill as well as fire itself and in some cases more people die from the smoke than the fire because the smoke can spread fast, starving the room of oxygen. Smoke can also burn as it can be very hot, causing lung injuries and burns to the respiratory system. Even a small amount of smoke can affect your sight and you can become disorientated and not be able to find an exit even in a familiar building.
Buildings will have plans in place to deal with smoke and the larger ones may have smoke vents or screens to divert the smoke away from areas where people or the exits are.