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Finally, for all outcomes but otitis media, lower respiratory infections and asthma, we excluded studies that exclusively assessed childhood exposure to SHS to best account for the exposure temporality reflected in the SHS definition in GBD

In Germany, Europe's largest market, cigarette sales fell by 2.3% in 2025

"While smokeless tobacco products may not expose people to the noxious effects of combustion, our study shows that they nonetheless have an adverse impact on vascular health

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This will not only delay treatment but may also require mid-course corrections and probably refinements at the end

All participants were informed that study participation could affect their smoking habits and cravings prior to providing written informed consent