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ECigIntelligence.com, the Britain-based independent resource that tracks regulations and market information for the e-cig sector, agrees that the TPD is not being implemented or enforced consistently

"People smoke fewer cigarettes today but are still clearly addicted, and the old scale -- while still reasonably effective -- was not designed to measure that," Foulds said

This latest survey does not capture why fewer people smoked cigarettes, but the number has been on the decline since the 1960s, after the US surgeon general released the first report on smoking and health that concluded that smoking causes serious health problems

The cohort has been followed up for 42 years