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While for most of the states we observed a declining trend in tobacco use after 2005, men and women in few states showed an increasing trend in tobacco use

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Similar sex effects have been observed previously, with women giving more positive responses to a feminine brand name (April) and males giving more positive responses to a masculine brand name (Frontiersman) when smoking identical cigarettes 36

Indigenous traditions saw it as a bridge between the material and spiritual realms

Dr Ram Moorthy, deputy chair of the BMA's board of science, said: "Tighter controls are needed to ensure their use does not undermine current tobacco control measures and reinforces the normalcy of smoking behaviour." That same concern has prompted ministers in Wales to have a public consultation on how to tackle e-cigarettes, including the possible first ban in the UK on their use indoors