The relationship between cigarettes and lung cancer was never established using an RCT. But the epidemiology was so compelling there that we are very confident in making bold claims policy-wise and medically about those things. The more you smoked, the more likely you were to have a higher hazard ratio of smoking than eating certain food or drinking certain water. This is now how we have to get to medicine 3.0 because what you've highlighted is a very important point that also gets lost in the culture of only the RCT is valuable.

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