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The research team stated, "Even after controlling for the effects of other factors such as socioeconomic status and alcohol consumption, there is a causal relationship between smoking status, smoking intensity, and abdominal obesity." They added, "Hormones affected by smoking, such as cortisol and sex hormones, did not have an impact." They also added, "Starting to smoke and continuing to smoke increases abdominal and visceral fat," and "Not starting or quitting smoking could reduce abdominal fat and its related diseases."

In the United States, a federal appeals court struck down similar packaging in 2012, two years after the Food and Drug Administration unveiled graphic warnings as part of the Family Smoking Prevention and Tobacco Control Act