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Various studies have indicated that smoking reduces life expectancy, increases overall medical costs and contributes to a loss of productivity.(1) Although the consequences are well known, the absolute number of smokers continues to increase worldwide, particularly in developing countries, indicating that having information regarding those consequences does not induce people to permanently abandon the smoking habit, nor does it prevent new smokers from taking up the habit.(2) Studies evaluating the smoking habit, together with the variables that affect the onset, maintenance and cessation of smoking have shown that, due to a combination of psychological, physiological and social variables, the problems related to tobacco consumption and nicotine dependence are extremely complex.(3) The assessment of nicotine dependence is indispensable in epidemiological studies and in investigations of the effects of nicotine, as well as in studies regarding the treatment of smoking and of the various smoking-related diseases

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[1] Reaching an estimated 43 million people through more than 400 newspapers throughout the United States, A Frank Statement to Cigarette Smokers and subsequent advertisements were designed by public relations firm Hill & Knowlton to socially engineer the public's perceptions of tobacco and to instill doubt about scientific research linking disease and smoking

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