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This may be because longer smoking duration is associated with several genetic changes19 produced by the accumulation of specific polycyclic aromatic hydrocarbons, aromatic amines and nitrosamines from tobacco smoke.20 Long periods of tobacco exposure can lead to alterations in the pulmonary microbiome and reduced microbial diversity that contribute to COPD progression.21,22 The results of this study show that the COPD risk increases with smoking intensity

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For economic reasons, a person would want to know that, as buying cigarettes gets increasingly expensive

If this technique were used in a PMTA review, in almost every plausible scenario, the analysis would be dominated by the detriments of smoking and unintended consequences arising from increased smoking through the denial of vaping products