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A large array of pack sizes and stick dimensions makes comparing price per cigarette or gram across products very difficult for consumers 26 Providing products in small sizes allows tobacco companies to preserve profits: products with a low upfront purchase cost helps people who smoke continue to afford tobacco rather than quit, and these products typically have a greater return per stick than products in a similar price segment but in a larger pack size

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The composition of Environmental tobacco smoke (ETS) is similar to fossil fuel combustion products that contribute to air pollution, and has been shown to be responsible for indoor particulate matter (PM) levels far exceeding official outdoor limits

While our study did not specifically investigate the mechanisms, we can propose hypotheses regarding the association between smoking and ALS