Health effects associated with smoking: a Burden of Proof study

Published October 10, 2022, in Nature Medicine (opens in a new window)


As a leading behavioral risk factor for numerous health outcomes, smoking is a major ongoing public health challenge. Although evidence on the health effects of smoking has been widely reported, few attempts have evaluated the dose–response relationship between smoking and a diverse range of health outcomes systematically and comprehensively. In the present study, we re-estimated the dose–response relationships between current smoking and 36 health outcomes by conducting systematic reviews up to 31 May 2022, employing a meta-analytic method that incorporates between-study heterogeneity into estimates of uncertainty. Among the 36 selected outcomes, 8 had strong-to-very-strong evidence of an association with smoking, 21 had weak-to-moderate evidence of association and 7 had no evidence of association. By overcoming many of the limitations of traditional meta-analyses, our approach provides comprehensive, up-to-date and easy-to-use estimates of the evidence on the health effects of smoking. These estimates provide important information for tobacco control advocates, policymakers, researchers, physicians, smokers, and the public.

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Dai X, Gil GF, Reitsma MB, et al. Health effects associated with smoking: a Burden of Proof study. Nature Medicine. 10 October 2022. doi: 10.1038/s41591-022-01978-x.