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Thats because the equivalent of smoking a pack a day for 20 years could mean smoking half a pack daily for 40 years, two packs a day for 10, or any other permutation that results in the required combination of smoking intensity and duration

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You have a product that's killing half a million people a year and you put it in the same agency that regulates cancer chemotherapy drugs, you can pull one of those drugs off the market if it kills 10 people, but you can't pull a product, cigarettes, which is the leading tobacco product off the market for killing half a million people a year

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Results from existing studies have been mixed, with some finding that dual use leads to mitigated health-related harms due to the overall decrease in the use of cigarettes 13