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This study evaluates the differential effect in the interplay between Smoking Prevalence (SP) and health care, employing the Healthcare Access and Quality (HAQ) index towards the TBLC mortality rates across diverse continents and globally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The data covering a 30-year period for 204 countries globally was categorised based on the level of SP (Low, Moderate, High, Critical) and the quality of healthcare access (Poor, Limited, Adequate, Optimal). A two-way ANOVA was utilised to analyse the patterns and variations in TBLC mortality rates across these categories, exploring the interactions between SP and the HAQ Index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Distinct patterns were observed in each continent, highlighting the complex interactions between the HAQ Index and SP, which lead to varying health outcomes. The results indicate that regions with an optimal HAQ Index and low SP have lower TBLC death rates, whereas those with a poor HAQ Index and critical SP exhibit higher death rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings emphasise the need to address both smoking prevalence and healthcare facilities globally. By improving healthcare access and reducing smoking rates, governments can significantly lower TBLC mortality rates. This study underlines the importance of integrating public health policies that limit smoking prevalence with enhancements in healthcare systems to promote better health and well-being.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12913-025-13508-9","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T12:53:35Z","timestamp":1759755215000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Global nexus of smoking prevalence, healthcare quality and respiratory cancer mortality: a cross-continental study"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2049-7977","authenticated-orcid":false,"given":"Lakindu","family":"Piumika","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1023-6618","authenticated-orcid":false,"given":"Disuri","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1301-2011","authenticated-orcid":false,"given":"Roshinie De","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7679-4164","authenticated-orcid":false,"given":"Ruwan","family":"Jayathilaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0995-5941","authenticated-orcid":false,"given":"Colinie","family":"Wickramaarachchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6716-0805","authenticated-orcid":false,"given":"Lochana","family":"Rajamanthri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"13508_CR1","unstructured":"World Health Organization. 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