how can tobacco cause cancer Smoking causes Tobacco and Cancer | Cancer

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(Average cigarette consumption reported on the BRFSS from 1990-1999 was consistent throughout the period, ranging from 19.4 to 20.8 cigarettes per day.) The difference between the 30 cigarettes per smoker calculated from the excise tax database and the 20 cigarettes per smoker reported to the BRFSS is likely due to a combination of underreporting by BRFSS respondents and smoking by state residents under the age of 18(1)

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Children and adolescents were asked to self-rate their health which was considered a confounding variable