For generations, the cigarette has worn the face of a lung disease, its deeper violence hidden behind the most visible wound it leaves. Medical voices are now insisting on a fuller reckoning: tobacco is a systemic poison, carried by the blood to every corner of the body, and the heart attacks and strokes it quietly engineers may claim lives long before any cancer appears. The distance between what smokers believe their risk to be and what it actually is may itself be one of the most consequential public health gaps of our time.