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When I started monkeying with automobiles about 1955, a "tuneup" was necessary at least twice a year. This usually involved removing spark plugs for cleaning & re-gapping, adjusting valve clearances, igniton timing, breaker point gap, idle mixture screw(s), carburetor float level, cleaning the air filter and refilling it with oil, and cleaning the crankcase vent tube. Every other tuneup might need new spark plugs, breaker points & condenser, igniton rotor & distributor cap. The adjustments were usually done by ear, like a banjo picker twisting the knobs until it sounds "right". In 1955, the engine might have been rebuilt at least once by 60,000 miles, and few customers would want to spend more than a couple bucks for repairs to a car with 90,000 miles on it. By the time it had 100,000 miles on it, it had earned it's keep, and was usually given away if someone could be found to take it.
Nowadays, There is usually no adjustments to make, and if one were to attempt to adjust something that has a screw or knob, the car would almost surely run far worse than before, if it runs at all. All adjustments necessary are taken care of by the on board computer(s), provided all the sensors and electronic control devices are still working properly. Spark plugs last 60,000 to 100,000 miles, air filters are made of paper and get replaced periodically, like other filters for oil and fuel. If it has spark plug wires (some newer cars don't) they need to be replaced every few years because of the extreme heat of modern engines, and the very high voltage they carry. Many cars have a timing belt or two, that need to be replaced every 60,000 to 90,000 miles.
So a "tuneup" no longer involves making any adjustments, no cleaning except perhaps the throttle body, if it hasn't been running smoothly of late. It will depend on the mileage since the previous service to determine which of the various components need to be replaced. If it hasn't been running well, or the "Check Engine" light has been on lately, the computer(s) will need to be consulted to see if there is any problem in the engine control system. Diagnosing computer troubles can involve a couple hours or more just to find one problem. When that one problem is found and repaired, another may then become evident. Because of the way some of the computers work, one problem may cause the computer to go into "limp mode" to continue running. It can't concern itself with other problems that may crop up as a consequence of the first problem. It makes sense to take care of each new problem or symptom as it arrives, rather than waiting just because no effect is apparent when driving the car.
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