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There are few if any attempts, however, to systematically and comprehensively evaluate the landscape of evidence on smoking risk across a diverse range of health outcomes, with most current research focusing on risk or attributable burden of smoking for a specific condition 7,15 , thereby missing the opportunity to provide a comprehensive picture of the health risk experienced by smokers

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Additionally, there may be unidentified confounding variables that could impact the outcomes

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[122] In 1890, James Buchanan Duke founded the American Tobacco Company (ATC) and put the machines into mass-productions, which led to a decline in chewing tobacco and pipe smoking use in the United States