Dr. Jennifer McKay with Avera McKennan says the reason this study is so important is because the rates of smoking and obesity are moving in opposite directions. Smoking rates have declined by 20% while obesity rates have increased by 48%. This study is important because it not only addresses mortality but also looks at quality of life adjusted mortality. If this trend continues, all of the health improvements we've seen in the past 30 years because of smoking cessation will be eclipsed by complications related to obesity.