When I mention that in regards to smoking I note that if you have a heart attack and you are a smoker - your smoking created that heart attack and the common spin or implication is that you would not have had that heart attack if you did not smoke.

No reputable medical study would get away with that. You always have a control cohort, and report the increase in a symptom. The sole exception is in the case where withholding treatment would be inhumane (i.e., for a condition with a known ~100% death rate, and the patient's consent), at which point you explain the dire need, and then you can take credit for each survivor. None of the major studies on smoking showing a causal link betwen smoking and heart failure can or do use that angle.

valguarnera@carrionfields.com