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Smoking remains one of the leading causes of lung cancer, chronic obstructive pulmonary disease, stroke, and cardiovascular disease

Key strengths include the exceptionally large sample size, long follow-up, and detailed adjustment for clinical, behavioral, and socioeconomic confounders, allowing robust assessment of interactions between initiation age and smoking intensity

Is the desire to smoke inherited from our parents

The study limitations include the inability to capture malformations in pregnancies that do not result in a live birth, and possible misclassification of outcome and of exposure to varenicline or to smoking