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Most smoking-related deaths arise from one of three types of disease: lung cancer, chronic obstructive pulmonary disease (COPD which incorporates emphysema and chronic bronchitis) and coronary heart disease (CHD)

With restrictions on the sales and marketing of cigarettes, tobacco companies have expanded and promoted non-cigarette tobacco products (sometimes called other tobacco products or OTP)

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The more conservative but broader estimates showed the top two cities with illicit tobacco products were, at 40%, New York, and, at 37%, Buffalo.[30] A still broader estimate produced figures of 59% in New York and 40% in Buffalo