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One issue is the lack of official standardised testing procedures

When we combined the three smoking categories into one category (ever smoker) for the i2b2 trained and tested analysis, this combined group had a specificity of 99% and sensitivity of 96%

Acknowledgements The views and opinions expressed in this manuscript are those of the authors only and do not represent the views, official policy, or position of the US Department of Health and Human Services, the US Food and Drug Administration, the National Institute of Health, or any affiliated institutions or agencies

When Alexander Payne decided he wanted his film set in the 1970s to feel like it had been made in the 1970s (even creating a fake Focus Features logo and degraded film stock), it was a no-brainer to include smoking