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Perhaps it takes a hospitalization for pneumonia to force a patient to give up smoking

1 2 Nicolaievsky & Maenchen-Helfen 2007, p

Although the epigenetic mechanisms by which benzo[a]pyrene and nicotine-induced alterations can be vertically transmitted has not been resolved, smoking-induced abnormal protamination may cause alterations in the methylation pattern of CpG in the promoter regions of DNA in the offspring of smokers [161]

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Hosmer, James Kendall (ed.)

The total economic burden attributable to tobacco use summed only the totals for current health expenditure for both smoked and smokeless tobacco