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Voulvoulis said his life-cycle analysis likely underestimated some of the impacts. Plastic pollution from cigarette butt disposal, for example, was not included, nor were harms related to electronic cigarettes

Increasing product labelling as a means of increasing public awareness holds significant policy implications, including sustained investment in evidence-based mass media campaigns as part of a comprehensive tobacco control strategy 24

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However, the rate of decline can vary among individuals

Women at higher risk The estimates were found to be higher in women who smoked between one and five cigarettes per day: 57% (all studies) to 119% (studies controlling for confounders) increased risk for heart disease, and 31% for stroke, compared with women who never smoked