Tobacco, in all its forms and at all doses, poses a major health risk and kills up to half of its users or 8 million people each year. More than 7 million of those deaths are the result of direct tobacco use, while around 1.3 million are the result of non-smokers being exposed to second-hand smoke (SHS). People with drug and alcohol tendencies are 2–4 times more likely to smoke than the general population.