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Using immunohistochemistry to quantify polarisation of M1 (iNOS) and M2 (CD206) phenotype in lung tissue, in normal lungs AMs did not show M1 or M2 polarisation and instead dual expressed both markers of polarity, with the majority negative for M1 and M2 markers.30 In smokers and in COPD disease severity, AMs increased dual expression of both M1 and M2 markers.30 In early lung cancer, tumour-associated macrophages (TAMs) also showed co-expression of M1 (chemokine (CXC motif) ligand 9 (CXCL9)) and M2 (matrix metalloproteinase (MMP-12)) phenotypic markers,34 with single cell RNA-sequencing of TAMs showing uniform M2-like signature with varying degrees of M1-like signature

In terms of mortality, in 2021, an estimated 20 deaths were attributed to tobacco smoking, including 15 male and 5 female deaths