This may be due to the existence of an alteration, one with malice or otherwise, [or] a major defect, PSA, another top grading company notes in its definition
In a world of poison, said one French politician who spent much of the war imprisoned by Nazis, the BBC became the great antiseptic. He would not have been aware of the BBCs shadowy counterpart, the collection of radio stations emanating from an old English estate in the village of Milton Bryan

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8 out of 10 cases are due to smoking
PMID 31593518
He points out, for instance, that Marlboros were marketed in the mid-1940s not for cowboy wanna-bes but for tenderfeet seeking "extreme mildness." The cigarettes even featured a "beauty tip," ruby-red edging at the unlighted end to better hide traces of a female smoker's lipstick