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It occurs due to the build up of scar tissue in the lungs, obstructing the normal airflow

In developing this proposed rule, FDA determined that the public holds misperceptions about the health risks caused by smoking and that warning statements focused on less-known health consequences of smoking paired with concordant color graphics would promote greater public understanding of the risks associated with cigarette smoking, especially given that the existing Surgeon General's warnings currently used in the United States have been shown to go unnoticed and be invisible. For the reasons discussed in the preamble to this proposed rule, FDA has determined that the proposed new cigarette health warnings will advance the Government's interest in promoting greater public understanding of the negative health consequences of cigarette smoking

therefore, sex was included as a stratification factor in the Cox model to allow for different baseline hazard functions by sex

Standard Methods for the Examination of Water and Wastewater (23rd ed.)