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If you were at all curious if it was possible to worsen the effects of smoking, all you really have to do is add alcohol

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The Global Burden of Disease estimates that in 2021, 107.71 deaths per 100,000 people in Bulgaria could be attributed to tobacco use a mortality rate that is 2-3 times higher than in the old EU member states.[1] In 2024, Dr Sabev and his team from the Institute for Economic Research at the Bulgarian Academy of Sciences, in collaboration with the Vienna Institute for International Economic Studies (wiiw) and the Bulgarian Smoke-Free Life Coalition, conducted a study into the potential fiscal and health benefits of increasing tobacco taxes in Bulgaria.[2] The research compared the outcomes of three simulated scenarios against a baseline scenario reflecting the planned increase in excise duties in accordance with the 2022 Excise Duties and Tax Warehouses Act (hereafter referred to as the old plan )

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