A case of breathing trouble at a ski resort suggests that lung damage from clove cigarettes may show up and cause serious problems at high altitudes.

The 29-year-old skier had smoked 1 1/2 of the cigarettes a few days before beginning her vacation, Dr. Peter H. Hackett writes in the Journal of the American Medical Association. After two days on the mountain -- at an altitude of about 10,000 feet -- she developed a headache, cough, poor exercise performance and trouble breathing.

She had high-altitude pulmonary edema, or fluid in the lungs. But on several previous high-altitude trips, she had had no lung problems. "Although the cause and effect cannot be established," Hackett and several colleagues write, "we postulate that lung injury from the clove cigarettes may have predisposed this particular patient" to the lung problem.

Clove cigarettes, made in Indonesia, are about 40 percent tobacco and 60 percent ground clove. Levels of tar, nicotine and carbon monoxide are higher than for regular cigarettes. About 150 million are smoked in the United States each year.

The Specialty Tobacco Council Inc., which represents clove cigarette importers, says there is "no scientific or medical proof" that the cigarettes pose a health threat, although the American Lung Association has warned against their use at any altitude.