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The founders of Juul, Adam Bowen and James Monsees, have famously said they came up with their product while taking a smoke break at Stanford University in the early 2000s

Bradford Hill, whose paper is published in the opening pages of this issue, have carried out a meticulously conducted inquiry, the results of which have very serious implications, for they conclude that smoking is a factor, and an important factor, in the production of carcinoma of the lung The practical question which the doctor in practice has to answer is whether any of his patients-for instance, those with smokers cough-should be advised to give up smokingThere is no evidence about the degree of risk which cigarette smokers take, but it does apparently increase in direct proportion to the amount smoked daily and to the total duration of the habit. PRIMARY PULMONARY MALIGNANCY Treatment by Total Pneumonectomy