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A pack year is smoking an average of one pack of cigarettes per day for one year

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Beyond Cigarettes: The Risks of Non-Cigarette Nicotine Products and Implications for Tobacco Control BACKGROUND Whereas much is known about the effects of tobacco use, the current state of knowledge regarding non-cigarette nicotine products, such as electronic nicotine delivery systems (e-cigarettes and other vaping devices), water pipe/hookah, smokeless tobacco, pipes, cigars, little cigars, and cigarillos, that do not contain tobacco is not robust enough to yield a definitive consensus regarding their relative risks and benefits