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Addict Behav 36(12):144147 (Epub 2010 Sep 24) Hughes JR (2007) Effects of abstinence from tobacco: etiology, animal models, epidemiology, and significance: a subjective review

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A 20 pack years of smoking history means smoking one pack of cigarettes per day for 20 years, smoking two packs for 10 years, or any other pack-year combination that multiplied gives twenty

Tobacco cigarettes contain nicotine, a highly addictive substance that leads to long-term dependency and health issues like lung cancer, heart disease, and respiratory problems