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Hens believes his very authorial persona was forged in the crucible of his emergent addiction, for, on experiencing his first nicotine rush: I became myself for the very first time. And the sort of self he became was a writerly one: I not only saw images, not only heard single words or sentences, but experienced an inner world

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Indeed, COPD stages 1 and 2 and the presence of emphysema were shown to be among the strongest independent risk factors for lung cancer, with respective hazard ratios of 1.4 and 3.5 in the Pittsburgh Lung Screening Study cohort [23, 60]