Both my daughters smoke. This fact annoys me greatly, not only because of the damage they are knowingly doing to themselves but also because it underscores the apparently insurmountable difficulties all of us have in trying to minimise the enormous health effect of this chronic self-poisoning. Why do intelligent, well-informed people like my daughters not give up this habit? Is it because of the chemical addiction originated by the first puff and enhanced by subsequent ones,¹ emotional dependence, provision of stress relief, the power of routine practices, social pressures and coziness, lack of information, the infinite capability that people have for denying threatening realities, the unwillingness of governments to reduce important revenue source or all of the above? I do not know the answer to this question, nor can I explain the failure of humankind to eliminate smoking, by far the most important modifiable risk factor for diseases of all body systems of users, and, in the form of second-hand smoke, of people in their environment. Smoking rates increase steeply the world over, mainly as a result of higher consumption in developing countries. Furthermore, the decline in smoking rates in Western …