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Under long-term complications, chronic smoking accelerates the development of atherosclerosis, where fatty deposits build up in the arteries, leading to chronic cardiovascular issues

December 2011

10.1016/j.ypmed.2019.105896 [DOI] [PubMed] [Google Scholar] Sifaneck S, Johnson B, & Dunlap E (2005)

Either way, hydration and kidney function make a big difference, because the more hydrated you are, the faster the body can flush residual cotinine, though overdoing fluids can dilute the sample (and raise a few eyebrows in the process)

The relationship between tobacco and disease had been observed sporadically for centuries